Preventing Delirium in the Intensive Care Unit

Critical Care Clinics

Volumn 29, Issue 1, 2013, Pages 51-65

  Brummel, Nathan E ^a,b   Girard, Timothy D ^a,b  

^a VANDERBILT UNIVERSITY SCHOOL OF MEDICINE   (United States)

^b VETERANS AFFAIRS MEDICAL CENTER   (United States)

Author keywords

Delirium; Intensive care unit; Prevention; Sedation

Indexed keywords

BENZODIAZEPINE; CHOLINESTERASE INHIBITOR; DEXMEDETOMIDINE; HALOPERIDOL; LORAZEPAM; MIDAZOLAM; OLANZAPINE; PROPOFOL; QUETIAPINE; RIVASTIGMINE; SEDATIVE AGENT;

AROUSAL; ARTIFICIAL VENTILATION; BREATHING; CRITICALLY ILL PATIENT; DELIRIUM; HIGH RISK PATIENT; HUMAN; INTENSIVE CARE; INTENSIVE CARE UNIT; MOBILIZATION; PRIORITY JOURNAL; REVIEW; RISK FACTOR; SEDATION; SLEEP DISORDER; SURGICAL PATIENT;

ANALGESICS, OPIOID; ANTIPSYCHOTIC AGENTS; CHEMOPREVENTION; COMORBIDITY; CRITICAL ILLNESS; DELIRIUM; HEALTH FACILITY ENVIRONMENT; HUMANS; HYPNOTICS AND SEDATIVES; IMMOBILIZATION; INTENSIVE CARE UNITS; LENGTH OF STAY; PAIN; PAIN MANAGEMENT; PATIENT ISOLATION; RESPIRATION, ARTIFICIAL; RISK FACTORS; SLEEP DEPRIVATION;

EID: 84870190044     PISSN: 07490704     EISSN: 15578232     Source Type: Journal    
DOI: 10.1016/j.ccc.2012.10.007     Document Type: Review

References (68)

1. American Psychiatric Association Diagnostic and statistical manual of mental disorders. Fourth edition, text revision 2000, American Psychiatric Association, Washington, DC.
2. Ely E.W., Inouye S.K., Bernard G.R., et al. Delirium in mechanically ventilated patients: validity and reliability of the confusion assessment method for the intensive care unit (CAM-ICU). JAMA 2001, 286(21):2703-2710.
3. Dubois M.J., Bergeron N., Dumont M., et al. Delirium in an intensive care unit: a study of risk factors. Intensive Care Med 2001, 27(8):1297-1304.
4. Bergeron N., Dubois M.J., Dumont M., et al. Intensive Care Delirium Screening Checklist: evaluation of a new screening tool. Intensive Care Med 2001, 27(5):859-864.
5. Girard T.D., Kress J.P., Fuchs B.D., et al. Efficacy and safety of a paired sedation and ventilator weaning protocol for mechanically ventilated patients in intensive care (Awakening and Breathing Controlled trial): a randomised controlled trial. Lancet 2008, 371(9607):126-134.
6. Pandharipande P.P., Pun B.T., Herr D.L., et al. Effect of sedation with dexmedetomidine vs lorazepam on acute brain dysfunction in mechanically ventilated patients: the MENDS randomized controlled trial. JAMA 2007, 298(22):2644-2653.
7. Pandharipande P., Cotton B.A., Shintani A., et al. Prevalence and risk factors for development of delirium in surgical and trauma intensive care unit patients. J Trauma 2008, 65(1):34-41.
8. Guenther U., Popp J., Koecher L., et al. Validity and reliability of the CAM-ICU flowsheet to diagnose delirium in surgical ICU patients. J Crit Care 2010, 25(1):144-151.
9. Micek S.T., Anand N.J., Laible B.R., et al. Delirium as detected by the CAM-ICU predicts restraint use among mechanically ventilated medical patients. Crit Care Med 2005, 33(6):1260-1265.
10. Shehabi Y., Riker R.R., Bokesch P.M., et al. Delirium duration and mortality in lightly sedated, mechanically ventilated intensive care unit patients. Crit Care Med 2010, 38(12):2311-2318.
11. Ely E.W., Gautam S., Margolin R., et al. The impact of delirium in the intensive care unit on hospital length of stay. Intensive Care Med 2001, 27(12):1892-1900.
12. Ely E.W., Shintani A., Truman B., et al. Delirium as a predictor of mortality in mechanically ventilated patients in the intensive care unit. JAMA 2004, 291(14):1753-1762.
13. Ouimet S., Kavanagh B.P., Gottfried S.B., et al. Incidence, risk factors and consequences of ICU delirium. Intensive Care Med 2007, 33(1):66-73.
14. Thomason J.W., Shintani A., Peterson J.F., et al. Intensive care unit delirium is an independent predictor of longer hospital stay: a prospective analysis of 261 non-ventilated patients. Crit Care 2005, 9(4):R375-R381.
15. Milbrandt E.B., Deppen S., Harrison P.L., et al. Costs associated with delirium in mechanically ventilated patients. Crit Care Med 2004, 32(4):955-962.
16. Lin S.M., Liu C.Y., Wang C.H., et al. The impact of delirium on the survival of mechanically ventilated patients. Crit Care Med 2004, 32(11):2254-2259.
17. Pisani M.A., Kong S.Y., Kasl S.V., et al. Days of delirium are associated with 1-year mortality in an older intensive care unit population. Am J Respir Crit Care Med 2009, 180(11):1092-1097.
18. Van Rompaey B., Schuurmans M.J., Shortridge-Baggett L.M., et al. Long term outcome after delirium in the intensive care unit. J Clin Nurs 2009, 18(23):3349-3357.
19. Girard T.D., Jackson J.C., Pandharipande P.P., et al. Delirium as a predictor of long-term cognitive impairment in survivors of critical illness. Crit Care Med 2010, 38(7):1513-1520.
20. Brummel N.E., Jackson J.C., Torres R., et al. Does duration of ICU delirium predict long-term functional impairment?. Am J Respir Crit Care Med 2011, 183:A2653.
21. Inouye S.K., Charpentier P.A. Precipitating factors for delirium in hospitalized elderly persons. Predictive model and interrelationship with baseline vulnerability. JAMA 1996, 275(11):852-857.
22. Inouye S.K., Bogardus S.T., Charpentier P.A., et al. A multicomponent intervention to prevent delirium in hospitalized older patients. N Engl J Med 1999, 340(9):669-676.
23. Martinez F.T., Tobar C., Beddings C.I., et al. Preventing delirium in an acute hospital using a non-pharmacological intervention. Age Ageing 2012, 41(5):629-634.
24. Marcantonio E.R., Flacker J.M., Wright R.J., et al. Reducing delirium after hip fracture: a randomized trial. J Am Geriatr Soc 2001, 49(5):516-522.
25. Kalisvaart K.J., de Jonghe J.F., Bogaards M.J., et al. Haloperidol prophylaxis for elderly hip-surgery patients at risk for delirium: a randomized placebo-controlled study. J Am Geriatr Soc 2005, 53(10):1658-1666.
26. Larsen K.A., Kelly S.E., Stern T.A., et al. Administration of olanzapine to prevent postoperative delirium in elderly joint-replacement patients: a randomized, controlled trial. Psychosomatics 2010, 51(5):409-418.
27. Prakanrattana U., Prapaitrakool S. Efficacy of risperidone for prevention of postoperative delirium in cardiac surgery. Anaesth Intensive Care 2007, 35(5):714-719.
28. Patel R.P., Gambrell M., Speroff T., et al. Delirium and sedation in the intensive care unit: survey of behaviors and attitudes of 1384 healthcare professionals. Crit Care Med 2009, 37(3):825-832.
29. Barr J, Fraser GL, Puntillo K, et al. Clinical practice guidelines for the management of pain, agitation, and delirium in adult patients in the intensive care unit. Critical Care Medicine, in press.
30. Pandharipande P., Shintani A., Peterson J., et al. Lorazepam is an independent risk factor for transitioning to delirium in intensive care unit patients. Anesthesiology 2006, 104(1):21-26.
31. Riker R.R., Shehabi Y., Bokesch P.M., et al. Dexmedetomidine vs midazolam for sedation of critically ill patients: a randomized trial. JAMA 2009, 301(5):489-499.
32. Maldonado J.R., Wysong A., van der Starre P.J., et al. Dexmedetomidine and the reduction of postoperative delirium after cardiac surgery. Psychosomatics 2009, 50(3):206-217.
33. Jakob S.M., Ruokonen E., Grounds R.M., et al. Dexmedetomidine vs midazolam or propofol for sedation during prolonged mechanical ventilation: two randomized controlled trials. JAMA 2012, 307(11):1151-1160.
34. Payen J.F., Bosson J.L., Chanques G., et al. Pain assessment is associated with decreased duration of mechanical ventilation in the intensive care unit: a post Hoc analysis of the DOLOREA study. Anesthesiology 2009, 111(6):1308-1316.
35. Agarwal V., O'Neill P.J., Cotton B.A., et al. Prevalence and risk factors for development of delirium in burn intensive care unit patients. J Burn Care Res 2010, 31(5):706-715.
36. Van Rompaey B., Elseviers M.M., Schuurmans M.J., et al. Risk factors for delirium in intensive care patients: a prospective cohort study. Crit Care 2009, 13(3):R77.
37. Pisani M.A., Murphy T.E., Araujo K.L., et al. Benzodiazepine and opioid use and the duration of intensive care unit delirium in an older population. Crit Care Med 2009, 37(1):177-183.
38. Bailey P., Thomsen G.E., Spuhler V.J., et al. Early activity is feasible and safe in respiratory failure patients. Crit Care Med 2007, 35(1):139-145.
39. Morris P.E., Goad A., Thompson C., et al. Early intensive care unit mobility therapy in the treatment of acute respiratory failure. Crit Care Med 2008, 36(8):2238-2243.
40. Morris P.E., Griffin L., Berry M., et al. Receiving early mobility during an intensive care unit admission is a predictor of improved outcomes in acute respiratory failure. Am J Med Sci 2011, 341(5):373-377.
41. Schweickert W.D., Pohlman M.C., Pohlman A.S., et al. Early physical and occupational therapy in mechanically ventilated, critically ill patients: a randomised controlled trial. Lancet 2009, 373(9678):1874-1882.
42. Needham D.M., Korupolu R., Zanni J.M., et al. Early physical medicine and rehabilitation for patients with acute respiratory failure: a quality improvement project. Arch Phys Med Rehabil 2010, 91(4):536-542.
43. Needham D.M., Korupolu R. Rehabilitation quality improvement in an intensive care unit setting: implementation of a quality improvement model. Top Stroke Rehabil 2010, 17(4):271-281.
44. Needham D.M. Mobilizing patients in the intensive care unit: improving neuromuscular weakness and physical function. JAMA 2008, 300(14):1685-1690.
45. Cooper A.B., Thornley K.S., Young G.B., et al. Sleep in critically ill patients requiring mechanical ventilation. Chest 2000, 117(3):809-818.
46. Gabor J.Y., Cooper A.B., Crombach S.A., et al. Contribution of the intensive care unit environment to sleep disruption in mechanically ventilated patients and healthy subjects. Am J Respir Crit Care Med 2003, 167(5):708-715.
47. Hardin K.A. Sleep in the ICU: potential mechanisms and clinical implications. Chest 2009, 136(1):284-294.
48. Bourne R.S., Mills G.H. Sleep disruption in critically ill patients-pharmacological considerations. Anaesthesia 2004, 59(4):374-384.
49. Mistraletti G., Carloni E., Cigada M., et al. Sleep and delirium in the intensive care unit. Minerva Anestesiol 2008, 74(6):329-333.
50. Weinhouse G.L., Schwab R.J., Watson P.L., et al. Bench-to-bedside review: delirium in ICU patients-importance of sleep deprivation. Crit Care 2009, 13(6):234.
51. Van Rompaey B., Elseviers M.M., Van Drom W., et al. The effect of earplugs during the night on the onset of delirium and sleep perception: a randomized controlled trial in intensive care patients. Crit Care 2012, 16(3):R73.
52. Hu R.F., Jiang X.Y., Zeng Y.M., et al. Effects of earplugs and eye masks on nocturnal sleep, melatonin and cortisol in a simulated intensive care unit environment. Crit Care 2010, 14(2):R66.
53. Bourne R.S., Mills G.H., Minelli C. Melatonin therapy to improve nocturnal sleep in critically ill patients: encouraging results from a small randomised controlled trial. Crit Care 2008, 12(2):R52.
54. Gamberini M., Bolliger D., Lurati Buse G.A., et al. Rivastigmine for the prevention of postoperative delirium in elderly patients undergoing elective cardiac surgery-a randomized controlled trial. Crit Care Med 2009, 37(5):1762-1768.
55. Hudetz J.A., Patterson K.M., Iqbal Z., et al. Ketamine attenuates delirium after cardiac surgery with cardiopulmonary bypass. J Cardiothorac Vasc Anesth 2009, 23(5):651-657.
56. Shehabi Y., Grant P., Wolfenden H., et al. Prevalence of delirium with dexmedetomidine compared with morphine based therapy after cardiac surgery: a randomized controlled trial (DEXmedetomidine COmpared to Morphine-DEXCOM Study). Anesthesiology 2009, 111(5):1075-1084.
57. Girard T.D., Pandharipande P.P., Carson S.S., et al. Feasibility, efficacy, and safety of antipsychotics for intensive care unit delirium: the MIND randomized, placebo-controlled trial. Crit Care Med 2010, 38(2):428-437.
58. Wang W., Li H.L., Wang D.X., et al. Haloperidol prophylaxis decreases delirium incidence in elderly patients after noncardiac surgery: a randomized controlled trial. Crit Care Med 2012, 40(3):731-739.
59. Ely EW. MIND-ICU Study: delirium and dementia in veterans surviving ICU care. Accessed August 31, 2012. http://clinicaltrials.gov/ct2/show/NCT01211522.
60. Skrobik Y.K., Bergeron N., Dumont M., et al. Olanzapine vs haloperidol: treating delirium in a critical care setting. Intensive Care Med 2004, 30(3):444-449.
61. Devlin J.W., Roberts R.J., Fong J.J., et al. Efficacy and safety of quetiapine in critically ill patients with delirium: a prospective, multicenter, randomized, double-blind, placebo-controlled pilot study. Crit Care Med 2010, 38(2):419-427.
62. van Eijk M.M., Roes K.C., Honing M.L., et al. Effect of rivastigmine as an adjunct to usual care with haloperidol on duration of delirium and mortality in critically ill patients: a multicentre, double-blind, placebo-controlled randomised trial. Lancet 2010, 376(9755):1829-1837.
63. Morandi A., Brummel N.E., Ely E.W. Sedation, delirium and mechanical ventilation: the 'ABCDE' approach. Curr Opin Crit Care 2011, 17(1):43-49.
64. Vasilevskis E.E., Ely E.W., Speroff T., et al. Reducing iatrogenic risks: ICU-acquired delirium and weakness-crossing the quality chasm. Chest 2010, 138(5):1224-1233.
65. Vasilevskis E.E., Pandharipande P.P., Girard T.D., et al. A screening, prevention, and restoration model for saving the injured brain in intensive care unit survivors. Crit Care Med 2010, 38(Suppl 10):S683-S691.
66. Pandharipande P.P., Sanders R.D., Girard T.D., et al. Effect of dexmedetomidine versus lorazepam on outcome in patients with sepsis: an a priori-designed analysis of the MENDS randomized controlled trial. Crit Care 2010, 14(2):R38.
67. Spronk P.E., Riekerk B., Hofhuis J., et al. Occurrence of delirium is severely underestimated in the ICU during daily care. Intensive Care Med 2009, 35(7):1276-1280.
68. van Eijk M.M., van Marum R.J., Klijn I.A., et al. Comparison of delirium assessment tools in a mixed intensive care unit. Crit Care Med 2009, 37(6):1881-1885.