Patient Outcomes and Management Strategies for Intensive Care Unit (ICU)-Associated Delirium: A Literature Review
Open Access
- 2 June 2024
- journal article
- review article
- Published by Springer Nature in Cureus
- Vol. 16 (6) , e61527
Abstract
Delirium is a significant public health concern, with tremendous implications for patient outcomes. Intensive care unit (ICU)-related delirium is gaining attention due to the higher prevalence of delirium in ICU-admitted patients. The most common negative outcomes of ICU delirium include cognitive impairments, functional dependence, high incidence of mortality, extended stay in the ICU, and high costs. So far, no single etiological factor has been identified as the sole cause of delirium. Several functional, neurotransmitter, or injury-causing hypotheses have been proposed for ICU delirium. Several risk factors contribute to the development of delirium in patients admitted to the ICU. These are age, gender, types of sedation, physical restraints, medical and surgical interventions, pain, and extended stay in the ICU. The most commonly used assessment modules for ICU delirium are the PREdiction of DELIRium in ICu patients (PRE-DELIRIC), Early PREdiction model for DELIRium in ICu patients (E-PRE-DELERIC), and Lanzhou Model, Confusion Assessment Method for the Intensive Care Unit (CAM-ICU), Intensive Care Delirium Screening Checklist (ICDSC), and Delirium Rating Scale (DRS). There is no proper treatment for ICU delirium; however, it can be managed through various pharmacological and non-pharmacological interventions. Healthcare providers should receive constant education and training on delirium recognition, prevention, and management to enhance patient care and outcomes in the ICU. Further research is needed on the effective prevention and management of ICU delirium.Keywords
This publication has 56 references indexed in Scilit:
- Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) for the diagnosis of delirium in adults in critical care settingsCochrane Database of Systematic Reviews, 2023
- Anxiety and depression in intensive care patients six months after admission to an intensive care unit: A cohort studyIntensive and Critical Care Nursing, 2023
- Postoperative delirium is an independent factor influencing the length of stay of elderly patients in the intensive care unit and in hospitalJournal of Anesthesia, 2022
- Delirium in Intensive CareCurrent Anesthesiology Reports, 2021
- Delirium in critical illness: clinical manifestations, outcomes, and managementIntensive Care Medicine, 2021
- Pharmacological and non-pharmacological interventions to prevent delirium in critically ill patients: a systematic review and network meta-analysisIntensive Care Medicine, 2021
- Non-pharmacological interventions for preventing delirium in hospitalised non-ICU patientsCochrane Database of Systematic Reviews, 2021
- Association of Delirium With Long-term Cognitive DeclineJAMA Neurology, 2020
- Pharmacological interventions for the treatment of delirium in critically ill adultsCochrane Database of Systematic Reviews, 2019
- Portuguese version of the Delirium Rating Scale‐Revised‐98: reliability and validityInternational Journal of Geriatric Psychiatry, 2008