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Delirium common in patients during beginning of mechanical ventilation weaning

More than half of the participants in a randomized, controlled trial experienced delirium at the start of mechanical ventilation weaning, according to study results.

The researchers reported delirium at the beginning of weaning correlated with more respiratory and neurologic complications and a reduced probability of successful extubation.

“A majority of patients were delirious at weaning initiation, and delirium was associated with more neurological and respiratory complications and a prolongation of weaning, with less ventilator-free days up to day 60,” Armand M. Dessap, MD, professor of medicine at Universitè Paris Est Crèteil, and colleagues wrote.

Dessap and colleagues conducted a sub study of 70 participants from the B-type natriuretic peptide for fluid Management of Weaning trial to assess the impact of delirium during mechanical ventilation weaning and any associated alterations in the circadian rhythm of melatonin excretion.

The researchers reported that 61.4% of the patients had become delirious at the start of weaning.

Patients with delirium at the beginning of weaning exhibited more complications during the attempt (93% vs. 63%, P = .002).

Researchers also reported a higher prevalence of complications persisted in patients with delirium (OR = 5.95; 95% CI, 1.26-28.13).

There are some limitations to the study, according to the researchers.

“We did not explore sleep in our patients and aMT6s excretion was assessed only during 24 hours,” the researchers wrote. “The ancillary nature and monocentric design of this study and the specific inclusion and exclusion criteria used in the BMW trial may limit the generalizability of our findings; however, we included a mixed population of medical and surgical patients with various reasons for intubation.”

Disclosure: Dessap reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures. – by Ryan McDonald