Does this critically ill patient with delirium require any drug treatment?
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Delirium is a severe and frequent condition that occurs in 20–40% of patients admitted to the intensive care unit (ICU), with higher rates of 60–80% described in mechanically ventilated patients. The accumulated evidence in the past decades demonstrates that delirium is clearly associated with hospital mortality, lengths of stay, duration of mechanical ventilation and costs [1, 2]. Moreover, the presence of delirium and its duration and severity are risk factors for long-term cognitive impairment in patients surviving critical illness . Although agitated (hyperactive) delirium attracts the intensivist's attention and frequently requires interventions to prevent self-harm and control the symptoms, the hypoactive and mixed forms are extremely common and frequently associated with poor outcomes. However, to correctly diagnose patients with delirium regardless of its presentation form, it is mandatory to use valid and reproducible screening tools such as the Confusion Assessment Method...
Dr. Salluh is supported in part by an individual research grant from CNPq and FAPERJ.
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All authors declare that they have no conflict of interest.
- 4.Morandi A, Piva S, Ely EW et al (2017) Worldwide survey of the “Assessing Pain, Both Spontaneous Awakening and Breathing Trials, Choice of Drugs, Delirium Monitoring/Management, Early Exercise/Mobility, and Family Empowerment” (ABCDEF) Bundle. Crit Care Med. https://doi.org/10.1097/CCM.0000000000002640 PubMedCrossRefGoogle Scholar
- 5.Cavalcanti AB, Bozza FA, Machado FR et al (2016) Effect of a quality improvement intervention with daily round checklists, goal setting, and clinician prompting on mortality of critically ill patients: a randomized clinical trial. JAMA J Am Med Assoc. https://doi.org/10.1001/jama.2016.3463 CrossRefGoogle Scholar
- 13.Skrobik Y, Duprey MS, Hill NS, Devlin JW (2018) Low-dose nocturnal dexmedetomidine prevents ICU delirium: a randomized, placebo-controlled trial. Am J Respir Crit Care Med. https://doi.org/10.1164/rccm.201710-1995oc