[Explore objective clinical variables for detecting delirium in ICU patients: a prospective case-control study]

Area of Science:

• Critical care medicine
• Neuroscience
• Intensive care unit (ICU) patient management

Background:

• Delirium is a common complication in intensive care unit (ICU) patients, associated with adverse outcomes.
• Objective clinical variables for diagnosing delirium in ICU patients are not well-established.

Purpose of the Study:

• To explore objective clinical variables for diagnosing delirium in intensive care unit (ICU) patients.

Main Methods:

• A prospective case-control study included 43 adult postoperative ICU patients requiring mechanical ventilation.
• Patients were assessed using the Richmond Agitation Sedation Scale (RASS) and Confusion Assessment Method for the ICU (CAM-ICU).
• Electroencephalographic (EEG) variables, cerebral blood flow (CBF) index, ICU blood gas analysis, and prognostic outcomes were recorded and analyzed using binary logistic regression.

Main Results:

• Delirious patients showed significantly higher brain activity (P=0.034) and a higher incidence of trauma (P=0.031).
• Statistically significant differences were observed in pH (P=0.003), chloride concentration (P=0.019), magnesium concentration (P=0.035), and blood osmolality (P=0.014).
• Multivariate analysis identified pH (OR=1.446) and chloride (OR=0.708) as potential risk factors for delirium.

Conclusions:

• Brain activity may contribute to delirium diagnosis in ICU patients, warranting further research.
• pH and chloride levels are identified as potential risk factors for delirium in this patient population.