Ciro Paolillo

Emergency Physician & Professor @AOUI Verona #delirium #olderpatient #Emergencymedicine #geriatrics

[Alasdair MacLullich @A_MacLullich]

#Delirium treatment is much more complex: treat the cause(s) - usually more than 1, optimise physiology (e.g. hydrate), detect & treat distress, prevent complications (e.g. falls, pressure sores, aspiration), communicate with family, rehabilitate, etc.

#meded

[Alessandro Morandi @AleMorandi78]

I'm glad to share this review on the management o delirium in LTC @A_MacLullich @GeriSocITA @GiusepeBellelli @FerraraMCris @EDA_delirium @NydahlPeter @agilis https://t.co/GHN9dLjDv5

[Alasdair MacLullich @A_MacLullich]

Sometimes when the triggers of #delirium are not clear on with standard history & examination, a head-to-toe approach can help to uncover causes.

[Alasdair MacLullich @A_MacLullich]

2 millenia & counting. Hippocrates knew #delirium was a medical emergency.

Why is it still so often missed, misdiagnosed, or undertreated?

What are the barriers?

What are the solutions?

[Alasdair MacLullich @A_MacLullich]

"It's just the dementia progressing."

A very dangerous phrase in clinical care.

Acute change in someone with dementia? That's #delirium until proven otherwise.

↳ Don't put the stick in the patient's wheel.

#Delirium #Dementia

[Carlo D'Apuzzo @EMpillsdoc]

Cos'è lo #shock_settico_refrattario....
https://t.co/nHBLVGLmHQ

[Giuseppe Bellelli @GiuseppeBellel1]

Left Atrial Appendage Closure or Medical Therapy in Atrial Fibrillation. An interesting practice for the older pts. New England Journal of Medicine https://t.co/RV21ULrZ0a

[Ciro Paolillo @EDstudy]

3. In addition, standard #intensive care interventions linked to #delirium, such as #sedation, opioid administration and noradrenaline, are known to suppress glymphatic clearance.

[Ciro Paolillo @EDstudy]

There's new thinking on #delirium, which is pretty exciting stuff for us. https://t.co/Mr3SrEC6G8

[Ciro Paolillo @EDstudy]

2. common #delirium triggers, including #infection, #surgery and #sleep deprivation, have been shown to impair glymphatic function

[Nat Rev Neurology @NatRevNeurol]

New online! Glymphatic dysfunction: a unifying hypothesis for delirium https://t.co/snr6YzgyXe

[Alasdair MacLullich @A_MacLullich]

Pain can present as agitation in #delirium - assess and treat appropriately.

Haloperidol is a poor analgesic.

[Società Italiana di Gerontologia e Geriatria @GeriSocITA]

📄Delirium ed esiti clinici avversi, lo studio di Haapanen et al. pubblicato su Lancet sui dati della UK Biobank.

Lancet Healthy Longev. 2026. DOI: 10.1016/j.lanhl.2025.100816

[Alasdair MacLullich @A_MacLullich]

Clinical tip on #delirium: 'Hyperactive' delirium is when a person is agitated and restless. 'Hypoactive' is when they are sleepy and withdrawn. Some patients fluctuate between these two states.

[Ciro Paolillo @EDstudy]

A detailed medical history and comprehensive physical examination remain the cornerstone of assessing #delirium in short-stay units, such as the ED https://t.co/5G3TYeMqRk

[Ciro Paolillo @EDstudy]

Laboratory investigations should not be considered a shortcut for diagnosing #delirium in #older ED
patients.https://t.co/5G3TYeMqRk

[Ciro Paolillo @EDstudy]

My research is available on @ResearchGate: https://t.co/EM1dPPEFnF

[Alasdair MacLullich @A_MacLullich]

Every hospital should have a delirium champion. We have stroke and sepsis champions - why not #delirium?

#PatientSafety

[Ciro Paolillo @EDstudy]

Other recommendations that suggests that
commonly used antipsychotic drugs do not treat delirium

[Ciro Paolillo @EDstudy]

Two useful recommendations from Society of Critical Care Medicine Guidelines on Caring for Older Adults in the ICU https://t.co/MekcNujeS3

[Ciro Paolillo @EDstudy]

"We make no recommendation regarding the use
of antipsychotic medication in the treatment of de-
lirium in older adults with critical illness" #delirium #geriatrics