This document discusses delirium in the ICU, including its definition, categorization, causes, risk factors, diagnosis, monitoring, and treatment approaches. Delirium is an acute confusional state that can fluctuate between hyperactive, hypoactive, and mixed types. It is associated with worse outcomes for ICU patients and increases costs. Risk factors include older age, severity of illness, benzodiazepines use, and infection. Diagnosis involves tools like the ICDSC and CAM-ICU. Treatment focuses on both non-pharmacological measures and pharmacological interventions like haloperidol or atypical antipsychotics.
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Preventing and Treating Delirium in the ICU
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5. How is Delirium Categorised? Hyperactive Hypoactive Mixed 1.6% of cases, “ ICU psychosis ”, agitation, restlessness, “picking”, emotional lability 54.1% % of cases 43.5% of cases, “ encephalopathy ”, often unrecognised, withdrawal, flat affect, apathy, lethargy, decreased responsiveness, may be misdiagnosed as depression
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9. Why does delirium happen? Serotonin Acetylcholine Dopamine Opioids & benzo’s 2 o brain infection Decreased cerebral metabolism 1 o intracranial disease Systemic disease Hypoxia Metabolic derangement Withdrawal syndromes Toxins
10. Risk factors for delirium Van Rompaey Intensive and Critical Care Nursing 2008; 24: 98—107
11. Age Severity Benzo’s Pun & Ely, Chest 2007; 132: 624–636 Pandharipande et al, Anesthesiology 2006; 104: 21-26
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