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Delirium: acute cognitive dysfunction in the critically ill.

Pratik Pandharipande1, James Jackson, E Wesley Ely

  • 1Department of Anesthesiology/Division of Critical Care, Center for Health Services Research, Vanderbilt University School of Medicine, Nashville, TN 37232, USA. pratik.pandharipande@vanderbilt.edu

Current Opinion in Critical Care
|July 15, 2005
PubMed
Summary
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Delirium is common in critically ill patients and impacts outcomes. Routine monitoring and prevention strategies are crucial for improving patient prognosis and care.

Area of Science:

  • Critical care medicine
  • Neuroscience
  • Geriatrics

Background:

  • Sepsis management traditionally focuses on non-brain organs, despite the brain's high involvement.
  • Delirium, or acute confusional states, affects 10-80% of older hospitalized and ICU patients.
  • Delirium is often unrecognized (32-66% of cases) and is a significant predictor of poor hospital outcomes.

Purpose of the Study:

  • To review current knowledge on delirium in critically ill patients.
  • To highlight the importance of brain dysfunction in sepsis and critical illness.
  • To emphasize the need for routine delirium assessment and management.

Main Methods:

  • Review of recent studies and validated monitoring instruments for delirium.
  • Discussion of delirium pathophysiology, risk factors, and prognostic implications.

Related Experiment Videos

  • Exploration of prevention and treatment strategies, including ongoing clinical trials.

    • Main Results:

    • Delirium monitoring instruments have been validated for noncommunicative patients.
    • Nonpulmonary organ dysfunction, including delirium, significantly impacts mortality.
    • Delirium is an independent prognostic factor for mechanical ventilation duration, functional decline, and death.

    Conclusions:

    • Delirium is highly prevalent in critically ill patients.
    • Delirium has substantial prognostic implications for patient outcomes.
    • Routine monitoring and multimodal prevention strategies are essential for managing delirium.