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Delirium prevention and treatment
1Department of Medicine, Université de Montréal, Montréal, Québec, Canada. skrobik@sympatico.ca
Critical Care Clinics
|July 7, 2009
Summary
Delirium prevention in critical care may involve early mobilization and reduced sedative/opiate use. However, no treatments are proven effective once delirium is established, highlighting the need for further research.
Area of Science:
- Critical care medicine
- Intensive care unit (ICU)
- Neuroscience
Background:
- Delirium affects 35-80% of critically ill patients.
- Limited knowledge exists regarding delirium prevention and treatment in critical care.
- Consequences of delirium in critical care are significant.
Purpose of the Study:
- To review current understanding of delirium prevention and treatment in critical care.
- To identify potential nonpharmacologic and pharmacologic strategies.
- To highlight areas for future research, particularly concerning addiction.
Main Methods:
- Literature review of studies on delirium in critical care.
- Emphasis on nonpharmacologic approaches like early mobilization.
- Discussion of sedative and analgesic titration strategies.
- Consideration of alcohol abuse screening and management.
Main Results:
- Early mobilization is associated with improved outcomes and reduced "delirium days".
- Titration and reduction of opiates and sedatives may decrease subsyndromal delirium.
- Rigorous screening for alcohol abuse and appropriate management are crucial.
- No proven nonpharmacologic or pharmacologic interventions exist for established delirium.
Conclusions:
- Nonpharmacologic strategies like early mobilization show promise for delirium prevention.
- Optimizing sedative and analgesic regimens is important.
- Further addiction studies are urgently needed to address delirium in critical care settings.
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