Update on the Prevention and Treatment of Intensive Care Unit Delirium

Drug Update| March 15 2021 Update on the Prevention and Treatment of Intensive Care Unit Delirium CE Article Jennifer Marsh, PharmD; Jennifer Marsh, PharmD Jennifer Marsh is a Critical Care Pharmacist, Department of Pharmacy Services, Tampa General Hospital, 1 Tampa General Circle, Tampa, FL 33601 (jcaldwell@tgh.org). Search for other works by this author on: This Site PubMed Google Scholar Earnest Alexander, PharmD Earnest Alexander, PharmD Department Editor Earnest Alexander is Assistant Director, Clinical Pharmacy Services, Department of Pharmacy Services, Tampa General Hospital, Tampa, Florida. Search for other works by this author on: This Site PubMed Google Scholar AACN Adv Crit Care (2021) 32 (1): 5–10. https://doi.org/10.4037/aacnacc2021494 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Share Icon Share Facebook Twitter LinkedIn Email Tools Icon Tools Cite Icon Cite Get Permissions Citation Jennifer Marsh, Earnest Alexander; Update on the Prevention and Treatment of Intensive Care Unit Delirium. AACN Adv Crit Care 15 March 2021; 32 (1): 5–10. doi: https://doi.org/10.4037/aacnacc2021494 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search nav search search input Search input auto suggest search filter All ContentAACN Advanced Critical Care Search Advanced Search Delirium is defined as "a syndrome characterized by the acute onset of cerebral dysfunction with a change or fluctuation in baseline mental status, inattention, and either disorganized thinking or an altered level of consciousness."1(p282) Delirium has been associated with increased mortality, prolonged hospital and intensive care unit (ICU) stays, and the development of post-ICU cognitive impairment.1 Bedside clinicians must be able to identify both hyperactive and hypoactive delirium, between which patients may fluctuate (ie, have mixed delirium). Hyperactive delirium typically involves agitation, hallucinations, and delusions, whereas patients with hypoactive delirium may be calm or lethargic while experiencing confusion and sedation. In 2018 the Society of Critical Care Medicine published updated Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU (PADIS guidelines).2 Important updates from prior guidelines...