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1.
PLoS One ; 17(4): e0266056, 2022.
Article in English | MEDLINE | ID: covidwho-1785194

ABSTRACT

BACKGROUND: Ever since COVID-19 was declared a pandemic, the world medical landscape has changed dramatically. As cardiac surgeons we not only have the duty to protect our patients and staff from COVID-19 infection, but we are also tasked with the responsibility to ensure those cardiovascular patients awaiting surgery are not harmed from an extended delay in surgery as the world comes to a halt from COVID-19. Currently there is limited literature on the outcome of cardiac surgery in the pre-operative Covid positive group. In this study we aim to assess the safety and outcome of patients undergoing cardiac surgery following Covid-19 infection. PATIENTS AND METHODS: This was a single centre retrospective observational study. All patients undergoing open heart surgery at Institut Jantung Negara from June 2020 to July 2021 were included in this study. Patients who were Covid positive pre-operatively were identified. Data from patient medical records collected contemporaneously were reviewed and analysed, supplemented by telephone call interviews after discharge. RESULTS: 2368 patients underwent open heart surgery from June 2020 until July 2021 in our centre. Of these, 0.5% (12 patients) were identified as Covid positive pre-operatively. Mean age of patients were 59.1 ± 14.8 years old. Mean Ejection Fraction was 46.4 ± 12.9. Most patients (75%) were asymptomatic with covid infection and only one patient were admitted to hospital for Covid infection. Mean duration from Covid PCR positive swab to surgery were 46.3 ± 32.7days. Most of the patients (66.7%) underwent operation on an emergency or urgent basis. Median time to extubation was 1 day. Median ICU length of stay was 1 day. 25% patients required non-invasive ventilation post-operatively and one patient was discharged home on long term oxygen therapy. There were 2 deaths- none of which were covid related mortality. CONCLUSION: Cardiac surgery could be performed safely in patients with pre-operative Covid-19 infection after a period of recovery, especially in the asymptomatic to mild category of infection. Multi-disciplinary team approach may be useful in deciding the timing of surgery for complex cases.


Subject(s)
COVID-19 , Cardiac Surgical Procedures , Adult , Aged , COVID-19/epidemiology , Cardiac Surgical Procedures/adverse effects , Humans , Middle Aged , Pandemics , SARS-CoV-2 , Treatment Outcome
2.
Braz J Cardiovasc Surg ; 37(1): 99-109, 2022 03 10.
Article in English | MEDLINE | ID: covidwho-1743102

ABSTRACT

INTRODUCTION: The primary aim of this systematic review is to provide perioperative strategies to help restore or preserve cardiovascular services under threat from financial and personnel constraints imposed by the coronavirus disease 2019 (COVID-19) pandemic. METHODS: The Medical Literature Analysis and Retrieval System Online, Excerpta Medica dataBASE, Cochrane Central Register of Controlled Trials/CCTR, and Google Scholar were systematically searched using the search terms "(cardiac OR cardiology OR cardiothoracic OR surgery) AND (COVID-19 or coronavirus OR SARS-CoV-2 OR 2019-nCoV OR 2019 novel coronavirus OR pandemic)". Additionally, the webpages of relevant medical societies, including the World Federation Society of Anesthesiologists, the Cardiothoracic Surgery Network, and the Society of Thoracic Surgeons, were screened for relevant information. RESULTS: Whereas cardiac surgery and cardiology practices were reduced by 50-75% during the pandemic, mortality of patients with COVID-19 increased significantly. Healthcare workers are among those at high risk of infection with COVID-19. CONCLUSION: Hospitals must provide maximum protective equipment and training on how to use it to healthcare workers for their mutual protection. Triage management of patients - which accounts for patient's clinical status and risk-factor profile relatable to which services are available during the COVID-19 pandemic - is recommended. A strict reorganization of the hospital resources including preoperative, intraoperative, and postoperative detailed protective measures is necessary to reduce probability of vector contamination, to protect patients and the cardiovascular teams, and to permit safe resumption of cardiological and cardiac surgical activity.


Subject(s)
COVID-19 , Cardiac Surgical Procedures , Cardiology , Child , Humans , Pandemics/prevention & control , SARS-CoV-2
3.
CMAJ Open ; 10(1): E173-E182, 2022.
Article in English | MEDLINE | ID: covidwho-1737355

ABSTRACT

BACKGROUND: Surgical delay may result in unintended harm to patients needing cardiac surgery, who are at risk for death if their condition is left untreated. Our objective was to derive and internally validate a clinical risk score to predict death among patients awaiting major cardiac surgery. METHODS: We used the CorHealth Ontario Registry and linked ICES health administrative databases with information on all Ontario residents to identify patients aged 18 years or more who were referred for isolated coronary artery bypass grafting (CABG), valvular procedures, combined CABG-valvular procedures or thoracic aorta procedures between Oct. 1, 2008, and Sept. 30, 2019. We used a hybrid modelling approach with the random forest method for initial variable selection, followed by backward stepwise logistic regression modelling for clinical interpretability and parsimony. We internally validated the logistic regression model, termed the CardiOttawa Waitlist Mortality Score, using 200 bootstraps. RESULTS: Of the 112 266 patients referred for cardiac surgery, 269 (0.2%) died while awaiting surgery (118/72 366 [0.2%] isolated CABG, 81/24 461 [0.3%] valvular procedures, 63/12 046 [0.5%] combined CABG-valvular procedures and 7/3393 [0.2%] thoracic aorta procedures). Age, sex, surgery type, left main stenosis, Canadian Cardiovascular Society classification, left ventricular ejection fraction, heart failure, atrial fibrillation, dialysis, psychosis and operative priority were predictors of waitlist mortality. The model discriminated (C-statistic 0.76 [optimism-corrected 0.73]). It calibrated well in the overall cohort (Hosmer-Lemeshow p = 0.2) and across surgery types. INTERPRETATION: The CardiOttawa Waitlist Mortality Score is a simple clinical risk model that predicts the likelihood of death while awaiting cardiac surgery. It has the potential to provide data-driven decision support for managing access to cardiac care and preserve system capacity during the COVID-19 pandemic, the recovery period and beyond.


Subject(s)
COVID-19 , Cardiac Surgical Procedures , Adolescent , Cardiac Surgical Procedures/adverse effects , Humans , Ontario/epidemiology , Pandemics , Risk Factors , SARS-CoV-2 , Stroke Volume , Ventricular Function, Left
5.
BMJ Open ; 12(2): e057804, 2022 02 23.
Article in English | MEDLINE | ID: covidwho-1714417

ABSTRACT

INTRODUCTION: Patients undergoing heart valve surgery are predominantly transferred postoperatively to the intensive care unit (ICU) under continuous sedation. Volatile anaesthetics are an increasingly used treatment alternative to intravenous substances in the ICU. As subject to inhalational uptake and elimination, the resulting pharmacological benefits have been repeatedly demonstrated. Therefore, volatile anaesthetics appear suitable to meet the growing demands of fast-track cardiac surgery. However, their use requires special preparation at the bedside and trained medical and nursing staff, which might limit the pharmacological benefits. The aim of our work is to assess whether the temporal advantages of recovery under volatile sedation outweigh the higher effort of special preparation. METHODS AND ANALYSIS: The study is designed to evaluate the differences between intravenous sedatives (n=48) and volatile sedatives (n=48) in continued intensive care sedation. This study will be conducted as a prospective, randomised, controlled, single-blinded, monocentre trial at a German university hospital in consenting adult patients undergoing heart valve surgery at a university hospital. This observational study will examine the necessary preparation time, staff consultation and overall feasibility of the chosen sedation method. For this purpose, the continuation of sedation in the ICU with volatile sedatives is considered as one study arm and with intravenous sedatives as the comparison group. Due to rapid elimination and quick awakening after the termination of sedation, closer consultation between the attending physician and the ICU nursing staff is required, in addition to a prolonged setup time. Study analysis will include the required setup time, time from admission to extubation as primary outcome and neurocognitive assessability. In addition, possible operation-specific (blood loss, complications), treatment parameters (catecholamine dosages, lung function) and laboratory results (acute kidney injury, acid base balance (lactataemia), liver failure) as influencing factors will be collected. The study-relevant data will be extracted from the continuous digital records of the patient data management system after the patient has been discharged from the ICU. For statistical evaluation, 95% CIs will be calculated for the median time to extubation and neurocognitive assessability, and the association will be assessed with a Cox regression model. In addition, secondary binary outcome measures will be evaluated using Fisher's exact tests. Further descriptive and exploratory statistical analyses are also planned. ETHICS AND DISSEMINATION: The study was approved by the Institutional Ethics Board of the University of Frankfurt, Germany (#20-1050). Informed consent of all individual patients will be obtained before randomisation. Results will be disseminated via publication in peer-reviewed journals. TRIAL REGISTRATION NUMBER: Clinical trials registration (NCT04958668) was completed on 1 July 2021.


Subject(s)
Cardiac Surgical Procedures , Heart Valves , Adult , Critical Care/methods , Heart Valves/surgery , Humans , Intensive Care Units , Observational Studies as Topic , Prospective Studies , Randomized Controlled Trials as Topic
7.
J Am Heart Assoc ; 11(4): e023757, 2022 02 15.
Article in English | MEDLINE | ID: covidwho-1673583

ABSTRACT

Background Proctoring represents a cornerstone in the acquisition of state-of-the-art cardiovascular interventions. Yet, travel restrictions and containment measures during the COVID-19 pandemic limited on-site proctoring for training and expert support in interventional cardiology. Methods and Results We established a teleproctoring setup for training in a novel patent foramen ovale closure device system (NobleStitch EL, HeartStitch Inc, Fountain Valley, CA) at our institution using web-based real-time bidirectional audiovisual communication. A total of 6 patients with prior paradoxical embolic stroke and a right-to-left shunt of grade 2 or 3 were treated under remote proctorship after 3 cases were performed successfully under on-site proctorship. No major device/procedure-related adverse events occurred, and none of the patients had a residual right-to-left shunt of grade 1 or higher after the procedure. Additionally, we sought to provide an overview of current evidence available for teleproctoring in interventional cardiology. Literature review was performed identifying 6 previous reports on teleproctoring for cardiovascular interventions, most of which were related to the current COVID-19 pandemic. In all reports, teleproctoring was carried out in similar settings with comparable setups; no major adverse events were reported. Conclusions Teleproctoring may represent a feasible and safe tool for location-independent and cost-effective training in a novel patent foramen ovale closure device system. Future prospective trials comparing teleproctoring with traditional on-site proctoring are warranted.


Subject(s)
Cardiac Surgical Procedures , Telemedicine , COVID-19 , Cardiac Surgical Procedures/education , Foramen Ovale, Patent/surgery , Humans , Pandemics
8.
J Cardiothorac Surg ; 16(1): 361, 2021 Dec 31.
Article in English | MEDLINE | ID: covidwho-1599128

ABSTRACT

OBJECTIVES: The purpose of this study was to assess changes in cardiovascular disease severity, types, postoperative complications and prognosis during the COVID-19 pandemic and to explore possible influencing factors. METHODS: A total of 422 patients were enrolled in this study, and hospitalization and short-term follow-up data were retained. The patient population included 273 men and 149 women. Patients had a median (IQR) age of 54 (45-62) years and were divided into an observation group (130) and a control group (292), primarily according to severity of disease, disease types, baseline indexes, biochemical indexes, cardiac function indexes, complications and prognosis. RESULTS: During the COVID-19 pandemic, compared with the same period last year, there was a significant increase in patients with aortic dissection (27.69% vs 5.82%), a significant decrease in patients with valvular heart disease (43.08% vs 66.78%), and significantly increased emergency admission (50.00% vs 21.23%) and severity (54.62% vs 27.40%). Family company (76.37% vs 64.62%) was decreased, EuroSCORE [6.5 (2-9) vs 2 (0-5)] score, Pro-BNP [857.50 (241.00-2222.50) vs 542.40 (113.45-1776.75)] ng/L, six months mortality rate (18.46% vs 8.90%), and postoperative complications, including infected patients, atelectasis, pulmonary edema, and so on were increased, with longer length of stay in the ICU and hospital in COVID-19 pandemic. Survival analysis curve further demonstrated that it had an impact on the deaths of patients during the COVID-19 pandemic period. Through ROC analysis of the death factors of patients, it was concluded that Family company affected the death of patients, and the area under the curve was 0.654 (P < 0.05). CONCLUSIONS: In this study, we found that the admission rate of critically ill patients with cardiovascular disease, complications of cardiac surgery, and short-term mortality of patients all exhibited a short-term increase, family company may be a risk factors for short-term mortality, that may be related to public pressure caused by the COVID-19 pandemic.


Subject(s)
COVID-19 , Cardiac Surgical Procedures , Cardiac Surgical Procedures/adverse effects , Critical Illness/epidemiology , Female , Humans , Male , Middle Aged , Pandemics , Retrospective Studies , SARS-CoV-2
9.
J Cardiovasc Med (Hagerstown) ; 23(2): 75-83, 2022 02 01.
Article in English | MEDLINE | ID: covidwho-1591832

ABSTRACT

The impact of the coronavirus disease-2019 (COVID-19) pandemic forced the governments worldwide to deal with an unprecedented health crisis. The aim of this review is to summarize what happened to cardiac surgery worldwide during the first wave of this pandemic. A literature search was performed to extrapolate key concepts regarding guidelines and reorganization of cardiac surgery wards during COVID-19. Supporting literature was also included to discuss the hot topics related to COVID-19 and cardiac surgery. Hence, both official documents from national scientific societies and single- or multiple-center experiences during the pandemics are reviewed and discussed. In Italy, the first western country hit by the pandemic, two different models were proposed to cope with the need for ICU/ward beds and to reallocate cardiac surgical services: Hub-and-Spoke system ('Hubs', dedicated to perform urgent and nondeferrable surgery, and 'Spokes', turned into COVID centers) and/or a progressive reduction in surgical activity. Worldwide, several guidelines/consensus statements were published, suggesting how to deal with the outbreak. Two different approaches for stratifying surgical indications were proposed: dynamic, based on the number of hospitalized COVID-19 patients; static, based only on the severity of the cardiovascular disease. Moreover, the importance of personal protective equipment was stressed. Several measures should have been adopted to deal with an unprecedented need for healthcare resources allocation to care for COVID-19 patients, putting the healthcare systems under serious stress. Cardiac surgery has, as have most surgical activities, been asked to reduce its own activity, giving priority to emergency and nondeferrable cases.


Subject(s)
COVID-19 , Cardiac Surgical Procedures , Thoracic Surgery/organization & administration , Humans
12.
J Crit Care ; 67: 108-117, 2022 02.
Article in English | MEDLINE | ID: covidwho-1565598

ABSTRACT

PURPOSE: Cardiac surgery associated acute kidney injury (CSA-AKI) is a contributor to adverse outcomes. Preventive measures reduce AKI incidence in high risk patients, identified by biomarkers [TIMP-2]*[IGFBP7] (Nephrocheck®). This study investigate clinical AKI risk assessment by healthcare professionals and the added value of the biomarker result. MATERIALS AND METHODS: Adult patients were prospectively included. Healthcare professionals predicted CSA-AKI, with and without biomarker result knowledge. Predicted outcomes were AKI based on creatinine, AKI stage 3 on urine output, anuria and use of kidney replacement therapy (KRT). RESULTS: One-hundred patients were included. Consultant and ICU residents were best in AKI prediction, respectively AUROC 0.769 (95% CI, 0.672-0.850) and 0.702 (95% CI, 0.599-0.791). AUROC of NephroCheck® was 0.541 (95% CI, 0.438-0.642). AKI 3 occurred in only 4 patients; there was no anuria or use of KRT. ICU nurses and ICU residents had an AUROC for prediction of AKI 3 of respectively 0.867 (95% CI, 0.780-0.929) and 0.809 (95% CI, 0.716-0.883); for NephroCheck® this was 0.838 (95% CI, 0.750-0.904). CONCLUSIONS: Healthcare professionals performed poor or fair in predicting CSA-AKI and knowledge of Nephrocheck® result did not improved prediction. No conclusions could be made for prediction of severe AKI, due to limited number of events.


Subject(s)
Acute Kidney Injury , Cardiac Surgical Procedures , Acute Kidney Injury/etiology , Biomarkers , Cardiac Surgical Procedures/adverse effects , Cell Cycle Checkpoints , Delivery of Health Care , Humans , Insulin-Like Growth Factor Binding Proteins , Prospective Studies , Tissue Inhibitor of Metalloproteinase-2
13.
15.
Heart Surg Forum ; 24(6): E940-E946, 2021 11 12.
Article in English | MEDLINE | ID: covidwho-1538255

ABSTRACT

BACKGROUND: The aim of this study was to investigate the clinical outcomes of cardiac surgery in patients who were incidentally diagnosed with Covid-19 in the postoperative period. PATIENTS AND METHODS: We performed 826 open cardiac surgeries in five tertiary centers. Most of the surgeries were elective coronary artery bypass grafting (CABG) (93.8%). A preoperative RT-PCR test and transcutaneous oxygen saturation were routinely investigated prior to surgery. We also investigated whether the patients already received Covid-19 treatment or had any contact with a Covid-19 patient in the last two weeks. We analyzed high sensitive C-reactive protein (hs-CRP), d-dimer, and fibrinogen, which plays a main role in the activation of procoagulant state after surgeries. RESULTS: Acute lung injury related to Covid-19 activation was observed in 48 out of 826 patients (5.8%). The median age of 48 patients was 63.9±12.4 years. Euro-Score and body mass index (BMI) were 6.1±1.1 and 29.2±4.1kg/m², respectively. RT-PCR test results were positive in 29 patients (60.4%). We performed thoracic computed tomography (CT) in all patients with or without positive RT-PCR test results. Thoracic CT images showed that there was a different degree of ARDS (mild, moderate, and serious). The median time of extracorporeal circulation (ECC) was 93.2±14.6 min. in on-pump surgery (IQR, 68-155 min.). Common symptoms included dyspnea (N = 22; 45.8%) and fever (N = 12; 25%). Eleven patients needed readmission to ICU. Compared with non-admitted to ICU patients, ICU patients were higher comorbidities and severe laboratory abnormalities (eg, high blood d-dimer and fibrinogen). We also detected significantly low oxygen saturation, hypercapnia, and severe acidosis in readmitted patients. Radiologic investigations showed that there were severe ARDS with bilateral pneumonic infiltration resistant to medical treatment in 6 out of 11 patients who died (54.5%). CONCLUSION: Diffuse pneumonic infiltration related to Covid-19 may develop in asymptomatic cardiac surgery patients with negative RT-PCR test results. Immunologic disorders resulting from ECC, physiologic distress, and anesthesia may activate Covid-19 during the incubation period. We need randomized clinical trials to explain Covid-19 activation in the latent period of the virus, and clinical outcomes in cardiac surgery.


Subject(s)
Acute Lung Injury/diagnosis , Acute Lung Injury/virology , COVID-19/diagnosis , COVID-19/virology , Cardiac Surgical Procedures , Postoperative Period , Acute Lung Injury/diagnostic imaging , Aged , COVID-19/diagnostic imaging , COVID-19 Nucleic Acid Testing , Critical Care , Female , Humans , Incidental Findings , Male , Middle Aged , Patient Readmission , Retrospective Studies , SARS-CoV-2 , Stress, Physiological , Tomography, X-Ray Computed , Virus Activation
16.
Semin Cardiothorac Vasc Anesth ; 26(1): 27-31, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1506118

ABSTRACT

Anesthesiologists are important components of volunteer teams which perform congenital cardiac surgery in low-resource settings throughout the world, but limited data exist to characterize the nature and breadth of their work. A survey of Congenital Cardiac Anesthesia Society (CCAS) members was conducted with the objective of understanding the type of voluntary care being provided, its geographic reach, the frequency of volunteer activities, and factors which may encourage or limit anesthesiologists' involvement in this work. The survey was completed by 108 participants. Respondents reported a total of 115 volunteer trips during the study period, including work in 41 countries on 5 continents. Frequent motivating factors to begin volunteering included invitations from charitable groups, encouragement from senior colleagues, and direct connections to individual locations. Discouraging factors included familial responsibilities, the need to use vacation time, and a lack of support from home institutions. The year 2020 saw a marked decrease in reported volunteer activity, and respondents reported multiple pandemic-related factors which might discourage future volunteer activities. The results of this study demonstrate the global reach of anesthesiologists in providing care for children having cardiac surgery. It also offers insights into the challenges faced by interested individuals, many of which are related to a lack of institutional support. These challenges have only mounted under the COVID-pandemic, leading to a dramatic downturn in volunteer activities. Finally, the survey reinforces the need for better coordination of volunteer activities to optimize clinical impact.


Subject(s)
Anesthesia, Cardiac Procedures , COVID-19 , Cardiac Surgical Procedures , Anesthesiologists , Child , Humans , Surveys and Questionnaires
17.
Heart Surg Forum ; 24(5): E906-E908, 2021 Oct 21.
Article in English | MEDLINE | ID: covidwho-1502125

ABSTRACT

Coronavirus disease 2019 (COVID-19) is a highly contagious respiratory disease that threatens global health. During the pandemic period of COVID-19, the task for prevention in the general ward of cardiovascular surgery is fairly arduous. The present study intends to summarize our experience with infection control, including ward setting, admission procedures, personnel management, health education, and so on, to provide references for clinical management.


Subject(s)
COVID-19/prevention & control , Cardiac Surgical Procedures/standards , Cardiovascular Diseases/epidemiology , Guidelines as Topic , Pandemics/prevention & control , Patients' Rooms/standards , Tertiary Care Centers , COVID-19/epidemiology , Cardiovascular Diseases/surgery , China/epidemiology , Comorbidity , Humans , Retrospective Studies , SARS-CoV-2
18.
J Card Surg ; 37(1): 174-175, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1483915

ABSTRACT

Deferring nonemergent cardiac surgery became the strategy of choice for several international healthcare systems afflicted by high case burdens of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2/COVID-19) to both conserve valuable healthcare resources and protect patients from possible exposure. Missing from the available dataset to help guide policy development has been a clear understanding of the extent to which COVID-19 infection modulates cardiac surgery outcomes. In their investigation, Bonalumi et al. uncovered an inpatient COVID-19 positivity rate of almost 10 times higher than that of the general Italian population, as well as a mortality rate over 20 times higher amongst cardiac surgery patients with perioperative COVID-19 infection compared to those COVID-negative. While the summation of available evidence points to the serious consideration cardiac surgeons must give to delaying surgeries during the COVID-19 pandemic, recognition must be given to the risks that postponing cardiac surgery may have on patient outcomes. Emerging data is beginning to demonstrate the efficacy of vaccination in preventing postoperative COVID-19 infection and morbidity.


Subject(s)
COVID-19 , Cardiac Surgical Procedures , Elective Surgical Procedures , Humans , Pandemics , SARS-CoV-2
19.
Ann Thorac Surg ; 112(5): e377-e380, 2021 11.
Article in English | MEDLINE | ID: covidwho-1474341

ABSTRACT

Postinfarction ventricular septal rupture (VSR) represents a well-known mechanical complication of myocardial infarction, determining cardiogenic shock with high mortality rates. Surgical correction requires significant expertise to avoid cardiac rupture, uncontrollable bleeding, residual shunts, heart failure, and death. In the last year, we observed a substantial increase of VSR at our hospital, related to the delayed presentation of people with acute chest pain to the emergency departments during the coronavirus disease 2019 pandemic. We discuss our innovative triple-layer patch technique in a recent consecutive series of 8 patients. This technique proved effective in all patients, with no residual shunt or cardiac rupture.


Subject(s)
COVID-19/epidemiology , Cardiac Surgical Procedures/methods , Prostheses and Implants , Ventricular Septal Rupture/surgery , Aged , Comorbidity , Female , Humans , Male , Pandemics , Risk Factors , Ventricular Septal Rupture/diagnosis , Ventricular Septal Rupture/epidemiology
20.
Int J Environ Res Public Health ; 18(19)2021 09 26.
Article in English | MEDLINE | ID: covidwho-1463636

ABSTRACT

INTRODUCTION: Delirium is a common complication of patients hospitalized in Intensive care units (ICU). The risk of delirium is estimated at approximately 80% in intensive care units. In the case of cardiac surgery ICU, the risk of delirium increases due to the type of procedures performed with the use of extracorporeal circulation. The aim of this study was to provide an official translation and evaluation of Nursing Delirium Screening Scale (NuDESC) into Polish. The NuDESC scale is a scale used by nurses around the world to detect delirium at an early stage in treatment. METHODS: The method used in the study was the NuDESC tool, which was translated into Polish. The study was conducted by Cardiac ICU nurses during day shift (at 8 a.m.), night shift (at 8 p.m.) and in other situations where the patients showed delirium-like symptoms. RESULTS: Statistically significant differences were observed between the first and second day in the studied group of patients in the case of illusions/hallucinations. Delirium occurred more frequently during the night, but statistical significance was demonstrated for both daytime and nighttime shifts. It was not demonstrated in relation to the NuDESC scale in the case of insomnia disorders. The diagnosis of delirium and disorientation was the most common diagnosis observed in patients on the first day of their stay in the ICU, followed by problems with communication. Delirium occurred on the first day, mainly at night. On the second day, delirium was much less frequent during the night; the biggest problem was disorientation and problems with communication. CONCLUSION: This study contributed to the development of the Polish version of the scale (NuDESC PL) which is now used as the Polish screening tool for delirium detection. The availability of an easy-to-use nurse-based delirium instrument is a prerequisite for widespread implementation.


Subject(s)
Cardiac Surgical Procedures , Delirium , Nurses , Cardiac Surgical Procedures/adverse effects , Delirium/diagnosis , Humans , Intensive Care Units , Poland
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