UMEM Educational Pearls

Category: Critical Care

Title: Delirium in the Critically Ill

Posted: 10/16/2012 by Mike Winters, MD (Updated: 4/22/2024)
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Delirium in the Critically Ill

  • Delirium has been shown to be an independent predictor of mortality and can occur in up to 75% of critically ill patients.
  • Whether preventing or treating delirium in the critically ill patient, consider the following:
    • Minimize the use of anticholinergic medications (i.e. diphenhydramine, chlorpromazine)
    • Ensure pain is adequately controlled (avoid meperidine and tramadol)
    • Be careful with sedative medications; consider bolus dosing and daily interruption of continuous infusions
  • Additional measures to treat delirious patients include reducing sensory deprivation, promoting normal sleep-wake cycles, early physical rehabilitation, and treating psychosis.

References

Bienvenu OJ, Neufeld KJ, Needham DM. Treatment of four psychiatric emergencies in the intensive care unit. Crit Care Med 2012; 40:2662-2670.