Table 2.

Intensive care unit delirium—implications for clinical care

Delirium is a source of significant morbidity and mortality in critically ill patients. Although 1 d of delirium is associated with poor outcomes, a longer duration of delirium is associated with even worse outcomes.

Early identification of patients at risk for developing delirium and of patients with delirium is imperative for effective delivery of preventative and therapeutic interventions. Delirium assessments should be part of the ICU admission physical examination and should be incorporated into the daily work plan.

Modifiable patient-centered risk factors for delirium should be recognized and treated.

ICU-acquired risk factors are potentially modifiable and are closely interconnected. Multicomponent strategies can effectively limit these risk factors, and integration of these strategies into daily ICU practice can shorten the duration of ICU delirium and improve clinical outcomes.

Pharmacologic prevention and treatment for delirium (e.g., dexmedetomidine over benzodiazepines for sedation, antipsychotics) can be considered for individual patients, although the efficacy of these strategies is still unclear.

Definition of abbreviation: ICU = intensive care unit.