[Postoperative delirium and cognitive deficit. Prevention and therapy]

Area of Science:

• Critical Care Medicine
• Neuroscience
• Geriatrics

Context:

• Delirium is a common and serious condition in intensive care unit (ICU) patients.
• Current detection rates are low, with only one-third of delirious patients identified during routine care without validated tools.
• There is a need for improved strategies for delirium prevention and management in the ICU setting.

Purpose:

• To review current approaches to delirium prevention and therapy in ICU patients.
• To highlight the importance of validated monitoring tools for accurate delirium detection.
• To discuss the role of non-pharmacological and pharmacological interventions in managing ICU delirium.

Summary:

• Effective delirium management in ICUs involves regular monitoring with validated tools.
• Non-pharmacological interventions, including re-orientation and promoting patient autonomy, are crucial.
• Goal-directed sedation, alongside potential pharmacological agents targeting neurotransmitter systems, may aid prevention and treatment, though evidence quality varies.

Impact:

• Improved detection and management of delirium can lead to better patient outcomes in the ICU.
• Enhanced understanding of non-pharmacological and pharmacological strategies can guide clinical practice.
• Further research is needed to establish the efficacy and safety of pharmacological interventions for delirium.