Thieme E-Journals - Seminars in Neurology / Abstract

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// custom KV example window._adexc.push([ '/506/3014/', 'ut', '_kv', { 'IpLoggedIn':'false', 'LoggedIn':'false', 'isFulltext':'false', 'JournalDoi': '00000071', } ]); var axd = document.createElement('script'); axd.type = 'text/javascript'; axd.async = 1; axd.src = "https://dmp.theadex.com/d/506/3014/s/adex.js"; var s = document.getElementsByTagName('script')[0]; s.parentNode.insertBefore(axd, s); })(); </script>  <script src="https://polyfill.io/v3/polyfill.min.js?features=es6"></script> <script type="text/javascript" id="MathJax-script" async src="https://cdn.jsdelivr.net/npm/mathjax@3/es5/mml-chtml.js"></script> <meta name="page" content="abstract"/> <meta name="layout" content="main"/> <meta name="prism:publicationName" content="Seminars in Neurology" /> <meta name="prism:issn" content="0271-8235" /> <meta name="prism:eissn" content="1098-9021" /> <meta name="prism:distributor" content="Thieme Medical Publishers, Inc." /> <meta name="prism:copyright" content="Thieme Medical Publishers, Inc. 333 Seventh Avenue, 18th Floor, New York, NY 10001, USA" /> <meta name="prism:doi" content="10.1055/s-0044-1791246" /> <meta name="prism:academicField" content="Review Article" /> <meta name="prism:person" content="John W. Devlin" /> <meta name="prism:copyrightYear" content="2024" /> <meta name="prism:copyrighEntity" content="Thieme Medical Publishers, Inc." /> <meta name="prism:publicationDate" content="2024/09/23" /> <meta name="prism:coverDate" content="2024/12" /> <meta name="prism:volume" content="44" /> <meta name="prism:issueIdentifier" content="06" /> <meta name="prism:startingPage" content="762" /> <meta name="prism:endingPage" content="776" /> <meta name="prism:url" content="http://www.thieme-connect.de/products/ejournals/html/10.1055/s-0044-1791246" /> <meta name="citation_language" content="en" /> <meta name="citation_journal_title" content="Seminars in Neurology" /> <meta name="citation_journal_abbrev" content="Semin Neurol" /> <meta name="citation_issn" content="0271-8235" /> <meta name="citation_issn" content="1098-9021" /> <meta name="citation_publisher" content="Thieme Medical Publishers, Inc." /> <meta name="citation_doi" content="10.1055/s-0044-1791246" /> <meta name="citation_title" content="Pharmacologic Treatment Strategies for Delirium in Hospitalized Adults: Past, Present, and Future" /> <meta name="citation_author" content="John W. Devlin" /> <meta name="citation_author_institution" content="Department of Pharmacy and Health Systems Sciences, Bouve College of Health Sciences, Northeastern University, Boston, Massachusetts" /> <meta name="citation_author_institution" content="Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, Massachusetts" /> <meta name="citation_author_email" content="j.devlin@northeastern.edu" /> <meta name="citation_online_date" content="2024/09/23" /> <meta name="citation_publication_date" content="2024/12" /> <meta name="citation_volume" content="44" /> <meta name="citation_issue" content="06" /> <meta name="citation_firstpage" content="762" /> <meta name="citation_lastpage" content="776" /> <meta name="citation_pdf_url" content="http://www.thieme-connect.de/products/ejournals/pdf/10.1055/s-0044-1791246.pdf" /> <meta name="citation_fulltext_html_url" content="http://www.thieme-connect.de/products/ejournals/html/10.1055/s-0044-1791246" /> <meta name="citation_xml_url" content="http://www.thieme-connect.de/products/ejournals/xml/10.1055/s-0044-1791246.xml" format_fulltext="jats1.3" /> <meta name="citation_abstract_html_url" content="http://www.thieme-connect.de/DOI/DOI?10.1055/s-0044-1791246" /> <meta name="citation_license" content="[null, null]" /> <meta name="citation_abstract" content="<p>Despite the use of multidomain prevention strategies, delirium still frequently occurs in hospitalized adults. With delirium often associated with undesirable symptoms and deleterious outcomes, including cognitive decline, treatment is important. Risk-factor reduction and the protocolized use of multidomain, nonpharmacologic bundles remain the mainstay of delirium treatment. There is a current lack of strong evidence to suggest any pharmacologic intervention to treat delirium will help resolve it faster, reduce its symptoms (other than agitation), facilitate hospital throughput, or improve post-hospital outcomes including long-term cognitive function. With the exception of dexmedetomidine as a treatment of severe delirium-associated agitation in the ICU, current practice guidelines do not recommend the routine use of any pharmacologic intervention to treat delirium in any hospital population. Future research should focus on identifying and evaluating new pharmacologic delirium treatment interventions and addressing key challenges and gaps surrounding delirium treatment research.</p> " /> <meta name="citation_reference" content="citation_author=A JC Slooter; citation_author=W M Otte; citation_author=J W Devlin; citation_publication_date=2020; citation_title=Updated nomenclature of delirium and acute encephalopathy: statement of ten Societies; citation_firstpage=1020; citation_lastpage=1022; citation_issue=05; citation_journal_title=Intensive Care Med; citation_volume=46; " /> <meta name="citation_reference" content="citation_author=J E Wilson; citation_author=M F Mart; citation_author=C Cunningham; citation_publication_date=2020; citation_title=Delirium; citation_firstpage=90; citation_issue=01; citation_journal_title=Nat Rev Dis Primers; citation_volume=6; " /> <meta name="citation_reference" content="citation_author=K Gibb; citation_author=A Seeley; citation_author=T Quinn; 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citation_firstpage=174; citation_lastpage=185; citation_issue=01; citation_journal_title=Br J Anaesth; citation_volume=128; " /> <meta name="dc:medium" content="Seminars in Neurology" /> <meta name="dc:language" content="en" /> <meta name="dc:rights" content="Thieme Medical Publishers, Inc. 333 Seventh Avenue, 18th Floor, New York, NY 10001, USA" /> <meta name="dc:publisher" content="Thieme Medical Publishers, Inc." /> <meta name="dc:identifier" content="10.1055/s-0044-1791246" /> <meta name="dc:subject" content="Review Article" /> <meta name="dc:title" content="Pharmacologic Treatment Strategies for Delirium in Hospitalized Adults: Past, Present, and Future" /> <meta name="dc:creator" content="John W. Devlin" /> <meta name="dc:rightsHolder" content="Thieme Medical Publishers, Inc." /> <meta name="dc:date" content="2024/09/23" /> <meta name="dcterms:issued" content="2024/12" /> <meta name="dcterms:abstract" content="Despite the use of multidomain prevention strategies, delirium still frequently occurs in hospitalized adults. With delirium often associated with undesirable symptoms and deleterious outcomes, including cognitive decline, treatment is important. Risk-factor reduction and the protocolized use of multidomain, nonpharmacologic bundles remain the mainstay of delirium treatment. There is a current lack of strong evidence to suggest any pharmacologic intervention to treat delirium will help resolve it faster, reduce its symptoms (other than agitation), facilitate hospital throughput, or improve post-hospital outcomes including long-term cognitive function. With the exception of dexmedetomidine as a treatment of severe delirium-associated agitation in the ICU, current practice guidelines do not recommend the routine use of any pharmacologic intervention to treat delirium in any hospital population. Future research should focus on identifying and evaluating new pharmacologic delirium treatment interventions and addressing key challenges and gaps surrounding delirium treatment research. 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class="articleHeader"> <div xmlns:m="http://www.w3.org/1998/Math/MathML" xmlns:exsl="http://exslt.org/common" class="doi">Semin Neurol 2024; 44(06): 762-776<br>DOI: 10.1055/s-0044-1791246</div> <div class="articleType"> <div>Review Article</div> </div> <h1>Pharmacologic Treatment Strategies for Delirium in Hospitalized Adults: Past, Present, and Future</h1> <span id="authorlist"><span class="author"> <div class="name">John W. Devlin</div> <div class="affiliation"> <sup>1   </sup>Department of Pharmacy and Health Systems Sciences, Bouve College of Health Sciences, Northeastern University, Boston, Massachusetts</div> <div class="affiliation"> <sup>2   </sup>Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, Massachusetts</div> <div class="affiliation"></div> </span><a style="text-decoration: none;" class="toggle-affiliation-infos" href="#">&rsaquo; Author Affiliations<span class="verbum"></span></a></span> <div class="toggleMenu articleToggleMenu"> <a style="text-decoration: none;" href="#info"> &rsaquo; Further Information</a> </div> </div><ul class="tabBar borderBottom" id="articleTabs"> <li class="tab active"> <a href="#abstract">Abstract</a> </li> <li class="tab"> <a href="/products/ejournals/html/10.1055/s-0044-1791246">Full Text</a> </li> <li class="tab"> <a href="#references">References</a> </li> </ul><div id="sections"> <section id="abstract"> <div class="articleFunctions"> <input value="ai10.1055/s-0044-1791246,10.1055/s-0044-1791246" name="ai" type="hidden"> <div style="display: none" id="sfx10.1055/s-0044-1791246"> <a id="sfxServer" data-href="?id=doi:10.1055/s-0044-1791246&sid=Thieme:Connect&jtitle=Seminars in Neurology&issue=06&volume=44&date=2024&issn=0271-8235&spage=762&epage=776&aulast=Devlin&aufirst=John W.&__char_set=utf8&atitle=Pharmacologic Treatment Strategies for Delirium in Hospitalized Adults: Past, Present, and Future" target="sfx"><span class="articleAccessLabel sfx"><img id="sfxImageUrl" src="" alt="SFX Search" height="15" width="52"></span></a> </div> <a style="display: none" href="/products/ejournals/buyDocument/10.1055/s-0044-1791246" class="gotoLink" id="sasLink">Buy Article</a> <a data-url="https://s100.copyright.com/AppDispatchServlet" data-id="CCC RightsLink" data-target="CCC RightsLink" onClick="RightslinkPopUp("1098-9021", "Pharmacologic Treatment Strategies for Delirium in Hospitalized Adults: Past, Present, and Future", "09/23/2024", "John W. Devlin", "", "10.1055/s-0044-1791246", "762", "776", "44", "06", "")" class="gotoLink linkFunction" href="javascript:;">Permissions and Reprints</a> </div> <figure style="margin-left: 30px" class="floatRight"> <a data-doi="10.1055/s-0044-1791246" data-caption="" data-id="10-1055-s-0044-1791246_20240065-1.jpg" data-cssClass="previewOverlay" href="https://www.thieme-connect.de/media/sin/202406/lookinside/10-1055-s-0044-1791246_20240065-1.jpg" class="zoomFunction alignLeft"><img src="https://www.thieme-connect.de/media/sin/202406/lookinside/thumbnails/10-1055-s-0044-1791246_20240065-1.jpg"></a> <figcaption></figcaption> </figure> <a name="N10C17"></a> <h3>Abstract</h3> <p>Despite the use of multidomain prevention strategies, delirium still frequently occurs in hospitalized adults. With delirium often associated with undesirable symptoms and deleterious outcomes, including cognitive decline, treatment is important. Risk-factor reduction and the protocolized use of multidomain, nonpharmacologic bundles remain the mainstay of delirium treatment. There is a current lack of strong evidence to suggest any pharmacologic intervention to treat delirium will help resolve it faster, reduce its symptoms (other than agitation), facilitate hospital throughput, or improve post-hospital outcomes including long-term cognitive function. With the exception of dexmedetomidine as a treatment of severe delirium-associated agitation in the ICU, current practice guidelines do not recommend the routine use of any pharmacologic intervention to treat delirium in any hospital population. Future research should focus on identifying and evaluating new pharmacologic delirium treatment interventions and addressing key challenges and gaps surrounding delirium treatment research.</p> <i></i><i></i> <div class="articleKeywords"> <a name="N10C20"></a> <h3>Keywords</h3> delirium treatment - priorities - research methods - intensive care - anesthesiology - geriatrics </div> <br> <br> <a name="info"></a> <h3>Publication History</h3> <p>Article published online:<br>23 September 2024<br> </p> <p>© 2024. Thieme. All rights reserved.</p> <p>Thieme Medical Publishers, Inc.<br>333 Seventh Avenue, 18th Floor, New York, NY 10001, USA</p> <div id="trendmd-suggestions"></div> </section> <section id="htmlfulltext"> </section> <section id="references"> <a name=""></a> <ul class="literaturliste"> <a name="N11813"></a> <li> <h3>References</h3> </li> <li> <a name="JR20240065-1"></a><strong>1</strong> Slooter AJC, Otte WM, Devlin JW. et al. 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document.getElementById(sfxlink).removeAttribute("data-href"); } } } } } }; xmlHttp.send(query[count]); } } // Antwort des aktuellen Requests abwarten bevor der nächste gestartet wird if (xmlHttp && xmlHttp.readyState != 4) { window.setTimeout(function () { sendQuery(xmlHttp, url, query, count, false) }, 1000); // neue Anfrage starten falls nch weitere Elemente vorhanden sind } else if (query.length - count > 1){ window.setTimeout(function () { sendQuery(xmlHttp, url, query, count++, true) }, 1000); } return xmlHttp; } </script> <script type="text/javascript"> function RightslinkPopUp(publication, title, publicationDate, author, copyright, contentID, startPage, endPage, volumeNum, issueNum, license) { var url = "https://s100.copyright.com/AppDispatchServlet"; var location = url + "?publisherName=georgthieme" + "&publication=" + encodeURI (publication) + "&title=" + encodeURI (title) + "&publicationDate=" + encodeURI (publicationDate) + "&author=" + encodeURI (author) + "&copyright=" + encodeURI (copyright) + "&contentID=" + encodeURI (contentID) + "&startPage=" + encodeURI (startPage) + "&endPage=" + encodeURI (endPage) + "&volumeNum=" + encodeURI (volumeNum) + "&issueNum=" + encodeURI (issueNum) + "&orderSource=" + "&orderBeanReset=true"; if (license.length > 0) { location += "&oa=" + encodeURI (license) } PopUp = window.open(location, 'Rightslink', 'location=no,toolbar=no,directories=no,status=no,menubar=no,scrollbars=yes,resizable=yes,width=650,height=550'); } function RightslinkPopUpForBooks(publicationDate, author, contentId, bookTitle, title, isbn, sp, rpt) { var url = "https://s100.copyright.com/AppDispatchServlet"; var location = url + "?publisherName=georgthiemebks" + "&publicationDate=" + encodeURI (publicationDate) + "&author=" + encodeURI (author) + "&contentid=" + encodeURI (contentId) + "&bookTitle=" + encodeURI (bookTitle) + "&title=" + encodeURI (title) + "&ISBN=" + encodeURI (isbn) + "&sp=" + encodeURI (sp) + "&rpt=" + encodeURI (rpt) + "&publication=BOOK" + "&copyright=" + "&orderSource=" + "&orderBeanReset=true" PopUp = window.open(location, 'Rightslink', 'location=no,toolbar=no,directories=no,status=no,menubar=no,scrollbars=yes,resizable=yes,width=650,height=550'); } </script> <script type="text/javascript"> // holt sich das json Objekt und fuellt die Ausgaben-Dropdownbox function loadIssues(shortname, year) { // Volume-Anzeige in Abhängigkeit zur Zeitschrift anzeigen var isDisplayVolume = JSON.parse(document.toc.isDisplayVolume.value); // URL zum Abholen der Ausgaben zusammenbauen var url = jsContextPath + '/json/issues?shortname=' + shortname + '&year=' + year; // Request vorbereiten var xmlHttp = null; // Mozilla, Opera, Safari sowie Internet Explorer (ab v7) if (typeof XMLHttpRequest != 'undefined') { xmlHttp = new XMLHttpRequest(); } if (!xmlHttp) { // Internet Explorer 6 und älter try { xmlHttp = new ActiveXObject("Msxml2.XMLHTTP"); } catch (e) { try { xmlHttp = new ActiveXObject("Microsoft.XMLHTTP"); } catch (e) { xmlHttp = null; } } } // URL abschicken und Dropdownbox fuellen if (xmlHttp) { xmlHttp.open('GET', url, true); xmlHttp.onreadystatechange = function() { if (xmlHttp.readyState == 4) { var issues = eval('(' + xmlHttp.responseText + ')'); if (isDisplayVolume == true) { if (issues.length > 1) { var showVolume = false; var comparedIssue = null; var ids = []; for (var i = 0; i < issues.length; i++) { if (issues[i]['number'].indexOf('S ') > -1 || issues[i]['number'].toLowerCase() == issues[i]['number'].toUpperCase()) { if (comparedIssue == null) { comparedIssue = issues[i]; } ids.push(i); } } for (var i = 0; i < ids.length; i++) { if (issues[i]['volume'] != comparedIssue['volume']) { showVolume = true; break; } } } } var html = ""; for (var i = 0; i < issues.length; i++) { html += "<li><a href='"+jsContextPath+"/ejournals/issue/" + issues[i]['doi'] + "'>"; if (showVolume == true && issues[i]['volume'] != null && issues[i]['volume'].length > 0) { html += "Vol " + issues[i]['volume'] + " ("; } html += issues[i]['number']; if (showVolume == true && issues[i]['volume'] != null && issues[i]['volume'].length > 0) { html += ")"; } html += ": "; if(issues[i]['pages'] != null) { html += issues[i]['pages']; } html += "</a></li>" ; } $('#issue').html(html); $('#currentYear').html(year); } }; xmlHttp.send(null); } } // laedt beim Wechsel des Jahres die Dropdownboxen function getIssues(year) { // Ausgabenliste holen loadIssues(document.toc.shortname.value, year); } // laedt beim Refresh der Seite die Ausgabenliste function setIssues(year) { // falls nur eFirst vorhanden gar keine Ausgaben laden if (year > 0) { // Ausgabenliste holen loadIssues(document.toc.shortname.value, year); }else{ } } </script> <script type="text/javascript"> $(document).ready(function() { if ($("#crossrefcites").length > 0) { var doi = $("#crossrefcites").data("doi"); var ajaxUrl = jsContextPath + "/json/getCrossrefCites?doi=" + doi; $.ajax({ url: ajaxUrl, type: "GET", dataType: "html", success: function (data) { $('#crossrefcites').html(data); }, error: function (xhr, status) { console.log("Cannot retrieve crossref cites for the doi " + doi + "."); }, complete: function (xhr, status) { } }); } }); $('#crossrefcites').click(function(e){ var doi = $("#crossrefcites").data("doi"); var citesHTMLContent = "<div style=\"font-family: sans-serif; font-size: 12px; line-height: 140%\">"; citesHTMLContent += document.getElementById('crossrefCitesDetails').innerHTML; citesHTMLContent += "</div>"; var crossrefCitesWindowHeight = Math.floor($(window).height() / 2); var crossrefCitesWindowWidth = Math.floor($(window).width() / 2); var crossrefCitesWindowTop = Math.floor($(window).height() / 4); var crossrefCitesWindowLeft = Math.floor($(window).width() / 4); var crossrefCitesSize = "width="; crossrefCitesSize += crossrefCitesWindowWidth; crossrefCitesSize += ",height="; crossrefCitesSize += crossrefCitesWindowHeight; crossrefCitesSize += ",left="; crossrefCitesSize += crossrefCitesWindowLeft; crossrefCitesSize += ",top="; crossrefCitesSize += crossrefCitesWindowTop; crossrefCitesSize += ",scrollbars=1"; var crossrefCitesWindow = window.open("", "newWindow", crossrefCitesSize); crossrefCitesWindow.focus(); crossrefCitesWindow.document.writeln(); crossrefCitesWindow.document.writeln(citesHTMLContent); document.head.insertAdjacentHTML("afterbegin", "<style>body { font-size: 12px; line-height: 140%; font-family: sans-serif; color: #000; }"); crossrefCitesWindow.document.title = doi + " Crossref Cited-by"; crossrefCitesWindow.document.close(); }); </script> <script type="text/javascript"> $(".zoomFunction, .imageFunction, .audioFunction, .videoFunction, .podcastFunction").click(function() { var id = $(this).attr("data-id"); var caption = encodeURIComponent($(this).attr("data-caption")); var doi = $(this).attr("data-doi"); var mediaType = "image"; if ($(this).attr('class').indexOf('podcastFunction') > -1) { mediaType = "podcast"; } else if ($(this).attr('class').indexOf('audioFunction') > -1) { mediaType = "audio"; } else if ($(this).attr('class').indexOf('videoFunction') > -1) { mediaType = "video"; } submitMediaEvent(mediaType, id, caption, doi); }); function submitMediaEvent(mediaType, id, caption, doi) { const url = '/products/json/submitMediaStatisticsEvent?mediaType=' + mediaType + '&id=' + id + '&caption=' + caption + '&doi=' + doi; const request = $.ajax({ type : 'GET', async : true, cache: false, url, success : function(data) { } }); } $(".linkFunction").click(function() { var target = $(this).attr("data-target"); var id = $(this).attr("data-id"); var uri = encodeURIComponent($(this).attr("data-url")); const url = '/products/json/submitLinkStatisticsEvent?target=' + target + '&id=' + id + '&url=' + uri; const request = $.ajax({ type : 'GET', async : true, cache: false, url, success : function(data) { } }); 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Thieme E-Journals - Seminars in Neurology / Abstract