Delirium during Weaning from Mechanical Ventilation

Area of Science:

• Critical Care Medicine
• Neurology
• Geriatrics

Background:

• Delirium is a common complication in intensive care unit (ICU) patients.
• Understanding delirium incidence and risk factors post-extubation is vital for patient outcomes.

Purpose of the Study:

• To compare delirium incidence before and after extubation.
• To identify risk factors and predictors of delirium in extubated patients.

Main Methods:

• Prospective study including patients undergoing mechanical ventilation (MV) weaning and extubation.
• Delirium assessment using the Confusion Assessment Method for the ICU (CAM-ICU) twice daily.
• Analysis of risk factors including age, SOFA, APACHE scores, and neurological admission cause.

Main Results:

• 53.1% of 64 included patients developed delirium.
• Significant risk factors for delirium included older age, higher SOFA and APACHE scores, and neurological admission.
• Delirium onset was predominantly before or on the day of extubation; hypoactive delirium was most frequent.

Conclusions:

• Acute neurological injuries are key risk factors for delirium development.
• Delirium often manifests before or on extubation day and is frequently hypoactive, posing detection challenges.
• Prevention strategies should target neurological patients on MV, considering those still sedated.