Format

Send to

Choose Destination
Intensive Crit Care Nurs. 2018 Feb;44:110-114. doi: 10.1016/j.iccn.2017.07.013. Epub 2017 Aug 30.

The early diagnosis and management of mixed delirium in a patient placed on ECMO and with difficult sedation: A case report.

Author information

1
Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain; Universidad Autónoma de Madrid, Madrid, Spain. Electronic address: m.acevedo.nuevo@gmail.com.
2
Universidad Autónoma de Madrid, Madrid, Spain.
3
Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain.
4
Hospital Universitario La Princesa, Madrid, Spain.

Abstract

Delirium represents a serious problem that impacts the physical and cognitive prognosis of patients admitted to intensive care units and requires prompt diagnosis and management. This article describes the case and progress of a patient placed on Extracorporeal Membrane Oxygenation with difficult sedation criteria and an early diagnosis of mixed delirium. During the case report, we reflect on the pharmacological and non-pharmacological strategies employed to cope with delirium paying special attention to the non-use of physical restraint measures in order to preserve vital support devices (endotracheal tube or Extracorporeal Membrane Oxygenation cannula). The multimodal and multidisciplinary approach, focused on nursing interventions, strict Pain/Agitation/Delirium monitoring and pharmacological measures, as well as the implementation of measures according to the eCASH (early Comfort using Analgesia, minimal Sedatives and maximal Human Care) concept, were effective, resulting in a relatively short admission considering the severity of the patient's condition and the associated complications. Early independent ambulation was achieved prior to transfer to a hospitalisation unit.

KEYWORDS:

Case reports; Critical Care; Delirium; Extracorporeal Membrane Oxygenation; Nursing; Restraint, physical

PMID:
28869145
DOI:
10.1016/j.iccn.2017.07.013
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center