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Delirium in the intensive care unit.

Alessandro Morandi1, James C Jackson, E Wesley Ely

  • 1Center for Health Services Research, Vanderbilt Medical Center, Nashville, Tennessee 37232-8300, USA.

International Review of Psychiatry (Abingdon, England)
|February 17, 2009
PubMed
Summary

Intensive care unit (ICU) delirium, a brain dysfunction affecting up to 75% of critically ill patients, is linked to adverse outcomes. Modifying medication and implementing multicomponent interventions can help prevent and treat ICU delirium.

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Published on: September 24, 2020

Area of Science:

  • Critical care medicine
  • Neuroscience
  • Pharmacology

Background:

  • Delirium is a frequent complication in critically ill patients, with prevalence reaching 75% in intensive care units (ICUs).
  • ICU delirium is associated with significant adverse outcomes, including prolonged hospitalization, increased costs, higher mortality, and potential long-term cognitive impairment.
  • The exact pathophysiology of delirium remains unclear, but risk factors and contributing elements are being identified.

Purpose of the Study:

  • To review the current understanding of intensive care unit (ICU) delirium.
  • To highlight the association between medications (analgesics and sedatives) and delirium.
  • To discuss prevention and treatment strategies for ICU delirium.

Main Methods:

  • Review of existing literature on ICU delirium.
  • Analysis of risk factors, including pharmacological exposures.
  • Discussion of multicomponent interventions and treatment options.

Main Results:

  • Delirium in the ICU is common and associated with poor patient outcomes.
  • Medications used for pain and sedation in the ICU are potential risk factors for delirium.
  • Multicomponent interventions, adapted from non-ICU settings, show promise for delirium prevention.

Conclusions:

  • Reducing pharmacological exposure and implementing multicomponent interventions are key strategies for preventing ICU delirium.
  • Antipsychotic medications may be effective in treating diagnosed delirium.
  • Further research is needed to develop targeted interventions for delirium prevention in the ICU.