The delirious cardiac surgical patient: theoretical aspects and principles of management

Delirium, an etiologically nonspecific disorder of consciousness characterized by prominent deficits in attention, cognition, and perception, affects more than one-third of adult cardiac surgical patients. Despite the frequency of occurrence and the increased morbidity and mortality associated with it, the diagnosis is commonly late or missed, and management is less than optimal. This article addresses the recognition and management of delirium. Nurses who develop an index of suspicion for the diagnosis and acquire the diagnostic and interventional skills required to address this cerebral complication of cardiac surgery may well decrease its incidence and severity.