[Central anticholinergic syndrome in intensive care patients]

Intensive care patients develop altered patterns of behaviour for a variety of reasons. However, the drug therapy instituted to ameliorate these psychoreactive problems may give rise to complications such as the central anticholinergic syndrome. Cholinergic receptors are scattered at random throughout the central nervous system. The depression of cholinergic transmission is not only secondary to the administration of drugs but is also due to abnormalities affecting other transmitter systems. To date, no definitive criteria have been established for the diagnosis of the central anticholinergic syndrome. The diagnosis is made by exclusion and by the administration of physostigmine either as an i.v. bolus of 0.03 mg/kg or as an infusion at the rate of 1-2 mg/h.