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Delirium prevention and treatment
1Department of Medicine (Critical Care), Université de Montréal, Montréal, Québec, Canada. skrobik@sympatico.ca
Anesthesiology Clinics
|November 15, 2011
Summary
Early mobilization and reducing sedatives may prevent delirium in critical care. However, no treatments are proven effective once delirium develops, highlighting the need for more research into prevention and pharmacologic interventions.
Area of Science:
- Critical Care Medicine
- Neuroscience
- Geriatrics
Background:
- Delirium is a significant concern in critical care settings.
- Current knowledge on nonpharmacologic and pharmacologic delirium prevention and treatment is limited.
- Consequences of delirium in critical care necessitate further investigation.
Purpose of the Study:
- To review current understanding of delirium prevention and treatment in critical care.
- To identify effective nonpharmacologic and pharmacologic strategies.
- To highlight areas for future research.
Main Methods:
- Literature review of trials on early mobilization.
- Analysis of studies on sedative and opiate titration.
- Evaluation of alcohol abuse screening and management protocols.
Main Results:
- Early mobilization is associated with reduced delirium incidence.
- Titrating sedatives and opiates may improve subsyndromal delirium.
- No interventions have proven effective for established delirium.
Conclusions:
- Nonpharmacologic approaches like early mobilization show promise for delirium prevention.
- Careful management of alcohol withdrawal and sedation is crucial.
- Rigorous trials are urgently needed for both prevention and treatment of critical care delirium.
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