Prolonged Refractory ICU Delirium Successfully Treated With Valproic Acid: Case Report and Literature Review

Area of Science:

• Critical Care Medicine
• Neuroscience
• Pharmacology

Background:

• Intensive care unit (ICU) delirium presents as acute cerebral dysfunction, altering mental status.
• Standard management involves non-pharmacologic and pharmacologic interventions.
• Alternative treatments are sometimes necessary for refractory cases.

Observation:

• Valproic acid (VPA) is explored as a potential pharmacologic agent for ICU delirium.
• Evidence for VPA in ICU delirium is limited, especially in patients with substance abuse.
• A case study details a patient with refractory hyperactive ICU delirium and substance abuse history.

Findings:

• The patient, experiencing prolonged hyperactive ICU delirium despite multiple treatments, was successfully managed with VPA.
• This suggests VPA may be an effective option for complex ICU delirium cases.
• The study highlights VPA's potential utility in a challenging patient population.

Implications:

• Valproic acid (VPA) may offer a viable therapeutic option for refractory ICU delirium.
• Further research is warranted to establish VPA efficacy and safety in diverse ICU populations.
• This case contributes to understanding alternative pharmacologic strategies for critical care patients.