Delirium In ICU Case Study
Introduction
Delirium in the intensive care unit (ICU) is a common and clinically problematic condition that may increase the pressure of burden on the shoulders of the health system, and at the same time cause the process of healing derailed from its natural course. This rapidly developing and daily fluctuating disturbance of cognition and consciousness has four key elements according to the American Psychiatric Association’s (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV: 1) disturbance of consciousness with reduced awareness of the environment and impaired ability to focus, sustain or shift attention; 2) altered cognition or the development of a perceptual disturbance that is not better accounted for by preexisting or evolving dementia; 3) disturbance develops over a short period of time tends to fluctuate during the course of the day; and …show more content…
4) evidence of an etiologic cause(1).
It has been shown that delirious patients are at increased risk of self-extubation, catheter removal, prolonged mechanical ventilation, need for physical restraints, longer hospital stays, increased risk of mortality during hospitalization, and higher risk of institutionalization after discharge(2-6).
So, to increase the quality of caregiving and enhancing the outcome of patients, it is necessary to accurately predict and adequately treat delirium in ICU cases. Achieving this goal requires a good understanding of the condition; i.e. its definition, precipitating/risk factors, pathophysiology, and preventive/therapeutic approaches. Although delirium in the ICU may develop in any given patient, it is seen more frequently in vulnerable subjects, for example who have multiple predisposing factors that encounter a huge insult(s) (1).
Thus, this article seeks to provide a succinct but comprehensive review of the condition, aiming to help physicians in the ICU to have a better understanding of delirium in the ICU and act as efficiently as possible to decrease upcoming untoward consequences associated with
it.
Delirium in the intensive care unit (ICU) is a common and clinically problematic condition that may increase the pressure of burden on the shoulders of the health system, and at the same time cause the process of healing derailed from its natural course. This rapidly developing and daily fluctuating disturbance of cognition and consciousness has four key elements according to the American Psychiatric Association’s (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV: 1) disturbance of consciousness with reduced awareness of the environment and impaired ability to focus, sustain or shift attention; 2) altered cognition or the development of a perceptual disturbance that is not better accounted for by preexisting or evolving dementia; 3) disturbance develops over a short period of time tends to fluctuate during the course of the day; and …show more content…
4) evidence of an etiologic cause(1).
It has been shown that delirious patients are at increased risk of self-extubation, catheter removal, prolonged mechanical ventilation, need for physical restraints, longer hospital stays, increased risk of mortality during hospitalization, and higher risk of institutionalization after discharge(2-6).
So, to increase the quality of caregiving and enhancing the outcome of patients, it is necessary to accurately predict and adequately treat delirium in ICU cases. Achieving this goal requires a good understanding of the condition; i.e. its definition, precipitating/risk factors, pathophysiology, and preventive/therapeutic approaches. Although delirium in the ICU may develop in any given patient, it is seen more frequently in vulnerable subjects, for example who have multiple predisposing factors that encounter a huge insult(s) (1).
Thus, this article seeks to provide a succinct but comprehensive review of the condition, aiming to help physicians in the ICU to have a better understanding of delirium in the ICU and act as efficiently as possible to decrease upcoming untoward consequences associated with
it.