Delirium in the ICU Linked to Fatal Outcomes
Although intensive care teams have long been aware that a significant percentage of their patients develop delirium, this study establishes the most definitive link between delirium in the ICU and poor outcomes.
“Every patient who develops delirium will on average remain in the hospital at least one day longer,” says one of the study's authors Dr. Robert Stevens, a specialist in critical care and an associate professor at the Johns Hopkins University School of Medicine. Worse, “if you're admitted to the intensive care unit and you develop brain dysfunction, your risk of not surviving your hospital stay is doubled.”
Dr. Stevens and colleagues performed a systematic review and meta-analysis of available data on delirium in ICU patients. They sifted through 10,000 published reports before selecting 42 studies that met their specific criteria. They excluded studies that primarily enrolled patients with head injuries, strokes or other neurological disorders, or focused on sedation management or alcohol or substance withdrawal.
Delirium was identified in 5,280 of 16,595 (31.8 percent) critically ill patients reported in the 42 studies included in the meta-analysis. Dr. Stevens and his team found that delirium was associated with a twofold increase in hospital mortality even after adjusting for severity of illness.
Delirium is a type of brain dysfunction characterised by a sudden onset, fluctuating symptoms, inattention and confusion. One of the best known causes of delirium is medications given to ICU patients, such as sedatives. For example, benzodiazepine, which is commonly administered to patients to help them calm down and sleep, may ironically lead to disorientation and confusion. The use of such potentially harmful medications, particularly among higher risk populations (eg, the elderly and individuals with dementia), should be reduced or eliminated, the researchers say, adding that nighttime interruptions should also be minimised to ensure that patients get a good night’s rest without sedatives.
Notably, Dr. Stevens’ review also showed that among patients who develop delirium, the risk of long-term cognitive decline increases by 20 to 30 percent. “We’re seeing that even though you may have a very severe illness or injury and you’re lucky enough to survive, you’re still not quite out of the woods,” he says. “We need to think about the measures we can put into place to decrease these long-term burdens.”
Source: Johns Hopkins Medicine
Image credit: Flickr.com
Published on : Mon, 8 Jun 2015
Print as PDF
Features The SynoVent E5 is the ventilator you need with the interface you want. It does not only include advanced ventilator functionality for patients ranging from infant to adult, but also a modern, easy-to-use interface. The display can be configured...
FeaturesSV 300 is a state-of-the-art ventilator that’s simple to configure, easy to operate and versatile in use. It equips with extensive ventilation modes that can treats pediatric and adult patients with all acuity levels at ICUs and Intermediate Care.With...
The fully featured ICU ventilator, HAMILTON-MR1, guarantees uncompromised continuous ventilation care from the ICU to the MRI scanner and back. Its reliability and high performance, with advanced lung-protective strategies and patient-adaptive modes,...
Medos hemofilters pro are used for efficient and gentle hemofiltration during extracorporal circulation.Medos hemofilters pro do not need to be pre-flushed and can be used immediately. This guarantees a safe and quick hemofiltration.
medos customized tubing sets have been individually designed, so that all customer requirements, depending on application and need can be realized. Furthermore tubing sets can be refined by rheoparin or x.eed coating. Customized and standard tubing sets...