Prevalence, risk factors, and outcomes of delirium in mechanically ventilated adults

Critical Care Medicine

Volumn 43, Issue 3, 2015, Pages 557-566

  Mehta, Sangeeta ^a   Cook, Deborah ^b   Devlin, John W ^c   Skrobik, Yoanna ^d   Meade, Maureen ^e,f   Fergusson, Dean ^g   Herridge, Margaret ^h   Steinberg, Marilyn ^a   Granton, John ⁱ   Ferguson, Niall ^a   Tanios, Maged ^j   Dodek, Peter ^k   Fowler, Robert ^l,m   Burns, Karen ^m,n   Jacka, Michael ^o   Olafson, Kendiss ^p   Mallick, Ranjeeta ^g   Reynolds, Steven ^q,r   Keenan, Sean ^q,r   Burry, Lisa ⁱ  

^a MOUNT SINAI HOSPITAL   (Canada)

^b MCMASTER UNIVERSITY   (Canada)

^c NORTHEASTERN UNIVERSITY   (United States)

^d MAISONNEUVE ROSEMONT HOSPITAL   (Canada)

^e MCMASTER UNIVERSITY   (Canada)

^f HAMILTON HEALTH SCIENCES   (Canada)

^g OTTAWA HOSPITAL RESEARCH INSTITUTE   (Canada)

^h UNIVERSITY HEALTH NETWORK   (Canada)

ⁱ UNIVERSITY OF TORONTO   (Canada)

^j LONG BEACH MEMORIAL MEDICAL CENTER   (United States)

^k UNIVERSITY OF BRITISH COLUMBIA   (Canada)

^l SUNNYBROOK RESEARCH INSTITUTE   (Canada)

^m UNIVERSITY OF TORONTO   (Canada)

ⁿ ST MICHAEL'S HOSPITAL   (Canada)

^o UNIVERSITY OF ALBERTA HOSPITAL   (Canada)

^p UNIVERSITY OF MANITOBA   (Canada)

^q ROYAL COLUMBIAN HOSPITAL   (Canada)

^r SURREY MEMORIAL HOSPITAL   (Canada)

more..

Author keywords

Critical illness; Daily sedation interruption; Delirium; Mechanical ventilation; Sedation

Indexed keywords

DIMENHYDRINATE; DIPHENHYDRAMINE; FENTANYL; HALOPERIDOL; HYDROMORPHONE; LORAZEPAM; MIDAZOLAM; MORPHINE; OLANZAPINE; PROCHLORPERAZINE; QUETIAPINE; RISPERIDONE; TRAZODONE; ZOPICLONE; BENZODIAZEPINE DERIVATIVE; HYPNOTIC SEDATIVE AGENT; NARCOTIC ANALGESIC AGENT; NEUROLEPTIC AGENT;

ADULT; AGED; ALCOHOL CONSUMPTION; ARTICLE; ARTIFICIAL VENTILATION; CHECKLIST; COMA; CONTINUOUS INFUSION; CRITICALLY ILL PATIENT; DELIRIUM; DRUG DOSE TITRATION; FEMALE; HOSPITALIZATION; HUMAN; INTENSIVE CARE DELIRIUM SCREENING CHECKLIST; MAJOR CLINICAL STUDY; MALE; MULTICENTER STUDY; OUTCOME ASSESSMENT; PREVALENCE; PRIORITY JOURNAL; RANDOMIZED CONTROLLED TRIAL; RISK FACTOR; SECONDARY ANALYSIS; SEDATION; TOBACCO; TRACHEOSTOMY; AGE; APACHE; CLINICAL PROTOCOL; CLINICAL TRIAL; CONTROLLED STUDY; HEALTH BEHAVIOR; INTENSIVE CARE UNIT; LENGTH OF STAY; MIDDLE AGED; PROCEDURES; SEX DIFFERENCE; STATISTICS AND NUMERICAL DATA; TIME; VERY ELDERLY;

ADULT; AGE FACTORS; AGED; AGED, 80 AND OVER; ANALGESICS, OPIOID; ANTIPSYCHOTIC AGENTS; APACHE; BENZODIAZEPINES; CLINICAL PROTOCOLS; COMA; DELIRIUM; FEMALE; HEALTH BEHAVIOR; HUMANS; HYPNOTICS AND SEDATIVES; INTENSIVE CARE UNITS; LENGTH OF STAY; MALE; MIDAZOLAM; MIDDLE AGED; PREVALENCE; RESPIRATION, ARTIFICIAL; RISK FACTORS; SEX FACTORS; TIME FACTORS;

EID: 84924260187     PISSN: 00903493     EISSN: 15300293     Source Type: Journal    
DOI: 10.1097/CCM.0000000000000727     Document Type: Article

References (39)

1. Pandharipande P, Cotton BA, Shintani A, et al: Prevalence and risk factors for development of delirium in surgical and trauma intensive care unit patients. J Trauma 2008; 65:34-41
2. Ely EW, Shintani A, Truman B, et al: Delirium as a predictor of mortality in mechanically ventilated patients in the intensive care unit. JAMA 2004; 291:1753-1762
3. Ely EW, Gautam S, Margolin R, et al: The impact of delirium in the intensive care unit on hospital length of stay. Intensive Care Med 2001; 27:1892-1900
4. Pandharipande PP, Girard TD, Jackson JC, et al: Long-term cognitive impairment after critical illness. New Engl J Med 2013; 369:1306-1316
5. Witlox J, Eurelings LS, de Jonghe JF, et al: Delirium in elderly patients and the risk of postdischarge mortality, institutionalization, and dementia: A meta-analysis. JAMA 2010; 304:443-451
6. Milbrandt EB, Deppen S, Harrison PL, et al: Costs associated with delirium in mechanically ventilated patients. Crit Care Med 2004; 32:955-962
7. Lin SM, Huang CD, Liu CY, et al: Risk factors for the development of early-onset delirium and the subsequent clinical outcome in mechanically ventilated patients. J Crit Care 2008; 23:372-379
8. Ouimet S, Kavanagh BP, Gottfried SB, et al: Incidence, risk factors and consequences of ICU delirium. Intensive Care Med 2007; 33:66-73
9. Shehabi Y, Riker RR, Bokesch PM, et al SEDCOM (Safety and Efficacy of Dexmedetomidine Compared With Midazolam) Study Group: Delirium duration and mortality in lightly sedated, mechanically ventilated intensive care patients. Crit Care Med 2010; 38:2311-2318
10. Van Rompaey B, Elseviers MM, Schuurmans MJ, et al: Risk factors for delirium in intensive care patients: A prospective cohort study. Crit Care 2009; 13:R77
11. Dubois MJ, Bergeron N, Dumont M, et al: Delirium in an intensive care unit: A study of risk factors. Int Care Med 2001; 27:1297-1304
12. Pisani MA, Murphy TE, Araujo KL, et al: Benzodiazepine and opioid use and the duration of intensive care unit delirium in an older population. Crit Care Med 2009; 37:177-183
13. Barr J, Fraser GL, Puntillo K, et al; American College of Critical Care Medicine: Clinical practice guidelines for the management of pain, agitation, and delirium in adult patients in the intensive care unit. Crit Care Med 2013; 41:263-306
14. 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; 104:21-26
15. Mehta S, Burry L, Cook D, et al: Daily sedation interruption in mechanically ventilated critically ill patients cared for with a sedation protocol: A randomized controlled trial. JAMA 2012; 308:1985-1992
16. Bergeron N, Dubois MJ, Dumont M, et al: Intensive Care Delirium Screening Checklist: Evaluation of a new screening tool. Intensive Care Med 2001; 27:859-864
17. Riker RR, Picard JT, Fraser GL: Prospective evaluation of the Sedation-Agitation Scale for adult critically ill patients. Crit Care Med 1999; 27:1325-1329
18. Sessler CN, Gosnell MS, Grap MJ, et al: The Richmond Agitation- Sedation Scale: Validity and reliability in adult intensive care unit patients. Am J Respir Crit Care Med 2002; 166:1338-1344
19. Haenggi M, Blum S, Brechbuehl R, et al: Effect of sedation level on the prevalence of delirium when assessed with CAM-ICU and ICDSC. Intensive Care Med 2013; 39:2171-2179
20. Lin SM, Liu CY, Wang CH, et al: The impact of delirium on the survival of mechanically ventilated patients. Crit Care Med 2004; 32:2254-2259
21. Salluh JI, Soares M, Teles JM, et al; Delirium Epidemiology in Critical Care Study Group: Delirium epidemiology in critical care (DECCA): An international study. Crit Care 2010; 14:R210
22. Micek ST, Anand NJ, Laible BR, et al: Delirium as detected by the CAM-ICU predicts restraint use among mechanically ventilated medical patients. Crit Care Med 2005; 33:1260-1265
23. Thomason JWW, Shintani A, Peterson JF, 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:R375-R381
24. Lat I, McMillian W, Taylor S, et al: The impact of delirium on clinical outcomes in mechanically ventilated surgical and trauma patients. Crit Care Med 2009; 37:1898-1905
25. McPherson JA, Wagner CE, Boehm LM, et al: Delirium in the cardiovascular ICU: Exploring modifiable risk factors. Crit Care Med 2013; 41:405-413
26. Page VJ, Ely EW, Gates S, et al: Effect of intravenous haloperidol on the duration of delirium and coma in critically ill patients (Hope-ICU): A randomised, double-blind, placebo-controlled trial. Lancet Respir Med 2013; 1:515-523
27. 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; 104:21-26
28. Svenningsen H, Egerod I, Videbech P, et al: Fluctuations in sedation levels may contribute to delirium in ICU patients. Acta Anaesthesiol Scand 2013; 57:288-293
29. Mehta S, Devlin D, Skrobik Y, et al: Delirium, sub-syndromal delirium, antipsychotic use, and associated clinical outcomes in critically ill mechanically ventilated patients enrolled in the SLEAP multicenter randomized trial. Intensive Care Med 2012; 38:S128
30. Skrobik Y, Leger C, Cossette M, et al: Factors predisposing to coma and delirium: Fentanyl and midazolam exposure; CYP3A5, ABCB1, and ABCG2 genetic polymorphisms; and inflammatory factors. Crit Care Med 2013; 41:999-1008
31. Ely EW, Dittus RS, Girard TD: Point: Should benzodiazepines be avoided in mechanically ventilated patients? Yes. Chest 2012; 142:281-284; discussion 289
32. Skrobik Y: Counterpoint: Should benzodiazepines be avoided in mechanically ventilated patients? No. Chest 2012; 142:284-287
33. Kress JP, Pohlman AS, O'Connor MF, et al: Daily interruption of sedative infusions in critically ill patients undergoing mechanical ventilation. N Engl J Med 2000; 342:1471-1477
34. Anifantaki S, Prinianakis G, Vitsaksaki E, et al: Daily interruption of sedative infusions in an adult medical-surgical intensive care unit: Randomized controlled trial. J Adv Nurs 2009; 65:1054-1060
35. de Wit M, Gennings C, Jenvey WI, et al: Randomized trial comparing daily interruption of sedation and nursing-implemented sedation algorithm in medical intensive care unit patients. Crit Care 2008; 12:R70
36. Weisbrodt L, McKinley S, Marshall AP, et al: Daily interruption of sedation in patients receiving mechanical ventilation. Am J Crit Care 2011; 20:e90-e98
37. Girard TD, Kress JP, Fuchs BD, 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; 371:126-134
38. Strøm T, Martinussen T, Toft P: A protocol of no sedation for critically ill patients receiving mechanical ventilation: A randomised trial. Lancet 2010; 375:475-480
39. Burry L, Rose L, McCullagh I, et al: Daily sedation interruption versus no daily sedation interruption for critically ill adult patients requiring invasive mechanical ventilation. Cochrane Database Syst Rev 2014; 7:CD009176