UMEM Educational Pearls

Category: Critical Care

Title: Long-term complications of ICU Delirium

Keywords: delirium, dementia, ICU, (PubMed Search)

Posted: 10/25/2010 by Haney Mallemat, MD (Updated: 1/27/2023)
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Increasing literature demonstrates ICU delirium is bad. Delirium in mechanically ventilated patients is an independent predictor for long-term cognitive defects (e.g., managing money, following detailed instructions, reading maps, and developing dementia). The cited study found 80% of patients with ICU delirium had cognitive dysfunction at three months, and 70% had residual dysfunction at one year (33% had severe dysfunction).

You must be aggressive to prevent delirium:

-         Implement daily assessment tools (e.g., CAM-ICU)

-         Daily awakening and spontaneous breathing trials

-         Early patient mobilization

-         Aggressive pharmacological treatment of delirium

-         For more information: www.icudelirium.org

References

Delirium as a predictor of long-term cognitive impairment in survivors of critical illness. Girard, T., et al. Crit Care Med. 2010 Jul;38(7):1513-20.