Delirium in ICU
Treatment should start with:
- Early recognition of delirium
- Identifying any new underlying aetiologies
- Minimizing/eliminating predisposing and precipitating factors
One study involving 53 critically ill patients showed patients were exposed to an average of 11 risk factors each. Those with three or more risk factors had a 60% chance of developing delirium.
The mainstay of treatment must therefore focus on minimizing any risk factors.
On re-reviewing the list of predisposing factors, it is apparent that optimizing physiological and biochemical parameters, adjusting environmental issues and manipulating drug therapy are important considerations in preventing delirium in critically ill patients. Treatment options can broadly be categorised into pharmacological and non-pharmacological.