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Delirium in critically ill patients.

Peter Jackson1, Akram Khan2

  • 1Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, School of Medicine, Oregon Health & Science University, 3181 Southwest Sam Jackson Park Road, Portland, OR 97239, USA.

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Delirium in the intensive care unit (ICU) affects up to 87% of patients, increasing mortality and healthcare costs. This review covers its diagnosis, risk factors, and management strategies.

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Area of Science:

  • Critical Care Medicine
  • Neuroscience
  • Geriatrics

Background:

  • Delirium is a frequent complication in intensive care units (ICUs), with incidence rates between 45% and 87%.
  • It poses a substantial burden, linked to a 3.2-fold rise in 6-month mortality and significant healthcare expenditures.
  • Understanding delirium's impact is crucial for improving patient outcomes and optimizing resource allocation.

Purpose of the Study:

  • To review the current understanding of delirium in the ICU.
  • To discuss its diagnosis, epidemiology, and associated risk factors.
  • To outline the pathophysiology and emerging strategies for prevention and treatment.

Main Methods:

  • This is a review article, synthesizing existing literature.
  • It focuses on diagnostic criteria, epidemiological data, and identified risk factors for ICU delirium.
  • Pathophysiological mechanisms and current/developing interventions are also examined.

Main Results:

  • High incidence of ICU delirium confirmed, ranging from 45% to 87%.
  • Significant associations with increased mortality and substantial healthcare costs are highlighted.
  • Key risk factors and pathophysiological pathways are discussed.

Conclusions:

  • Delirium is a prevalent and serious condition in the ICU.
  • Effective diagnosis, risk factor identification, and management are essential.
  • Further research into prevention and treatment is warranted to mitigate its impact.