nach oben

Neurocritical Care

Erschienen in:

01.06.2011 | Review

Delirium and Sedation in the ICU

verfasst von: Jennifer A. Frontera

Erschienen in: Neurocritical Care | Ausgabe 3/2011

Einloggen, um Zugang zu erhalten

Abstract

Delirium is defined by a fluctuating level of attentiveness and has been associated with increased ICU mortality and poor cognitive outcomes in both general ICU and neurocritical care populations. Sedation use in the ICU can contribute to delirium. Limiting ICU sedation allows for the diagnosis of underlying acute neurological insults associated with delirium and leads to shorter mechanical ventilation time, shorter length of stay, and improved 1 year mortality rates. Identifying the underlying etiology of delirium is critical to developing treatment paradigms.

American Psychiatric Association. Diagnostic and statistical manual. 4th ed. Washington, DC: APA Press; 1994.

Kiely DK, Bergmann MA, Murphy KM, Jones RN, Orav EJ, Marcantonio ER. Delirium among newly admitted postacute facility patients: prevalence, symptoms, and severity. J Gerontol A Biol Sci Med Sci. 2003;58:M441–5.PubMed

Lawlor PG, Gagnon B, Mancini IL, et al. Occurrence, causes, and outcome of delirium in patients with advanced cancer: a prospective study. Arch Intern Med. 2000;160:786–94.PubMedCrossRef

McNicoll L, Pisani MA, Zhang Y, Ely EW, Siegel MD, Inouye SK. Delirium in the intensive care unit: occurrence and clinical course in older patients. J Am Geriatr Soc. 2003;51:591–8.PubMedCrossRef

Dyer CB, Ashton CM, Teasdale TA. Postoperative delirium. A review of 80 primary data-collection studies. Arch Intern Med. 1995;155:461–5.PubMedCrossRef

Francis J. Delirium in older patients. J Am Geriatr Soc. 1992;40:829–38.PubMed

Inouye SK, Rushing JT, Foreman MD, Palmer RM, Pompei P. Does delirium contribute to poor hospital outcomes? A three-site epidemiologic study. J Gen Intern Med. 1998;13:234–42.PubMedCrossRef

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;291:1753–62.PubMedCrossRef

Caeiro L, Ferro JM, Albuquerque R, Figueira ML. Delirium in the first days of acute stroke. J Neurol. 2004;251:171–8.PubMedCrossRef

10.

McManus J, Pathansali R, Hassan H, et al. The course of delirium in acute stroke. Age Ageing. 2009;38:385–9.PubMedCrossRef

11.

Sheng AZ, Shen Q, Cordato D, Zhang YY, Yin Chan DK. Delirium within three days of stroke in a cohort of elderly patients. J Am Geriatr Soc. 2006;54:1192–8.PubMedCrossRef

12.

Dysken MW, Skare SS, Burke MS, Mach JR Jr, Galka T, Billington CJ. Intrasubject reproducibility of growth hormone-releasing hormone-stimulated growth hormone in older women, older men, and younger men. Biol Psychiatry. 1993;33:610–7.PubMedCrossRef

13.

Tune L, Carr S, Cooper T, Klug B, Golinger RC. Association of anticholinergic activity of prescribed medications with postoperative delirium. J Neuropsychiatry Clin Neurosci. 1993;5:208–10.PubMed

14.

Figueroa-Ramos MI, Arroyo-Novoa CM, Lee KA, Padilla G, Puntillo KA. Sleep and delirium in ICU patients: a review of mechanisms and manifestations. Intensive Care Med. 2009;35:781–95.PubMedCrossRef

15.

Flacker JM, Lipsitz LA. Neural mechanisms of delirium: current hypotheses and evolving concepts. J Gerontol A Biol Sci Med Sci. 1999;54:B239–46.PubMedCrossRef

16.

Stefano GB, Bilfinger TV, Fricchione GL. The immune-neuro-link and the macrophage: postcardiotomy delirium, HIV-associated dementia and psychiatry. Prog Neurobiol. 1994;42:475–88.PubMedCrossRef

17.

Dasgupta M, Dumbrell AC. Preoperative risk assessment for delirium after noncardiac surgery: a systematic review. J Am Geriatr Soc. 2006;54:1578–89.PubMedCrossRef

18.

Fick DM, Agostini JV, Inouye SK. Delirium superimposed on dementia: a systematic review. J Am Geriatr Soc. 2002;50:1723–32.PubMedCrossRef

19.

Inouye SK, Zhang Y, Jones RN, Kiely DK, Yang F, Marcantonio ER. Risk factors for delirium at discharge: development and validation of a predictive model. Arch Intern Med. 2007;167:1406–13.PubMedCrossRef

20.

Lundstrom M, Edlund A, Bucht G, Karlsson S, Gustafson Y. Dementia after delirium in patients with femoral neck fractures. J Am Geriatr Soc. 2003;51:1002–6.PubMedCrossRef

21.

Pisani MA, Murphy TE, Van Ness PH, Araujo KL, Inouye SK. Characteristics associated with delirium in older patients in a medical intensive care unit. Arch Intern Med. 2007;167:1629–34.PubMedCrossRef

22.

Rudolph JL, Jones RN, Rasmussen LS, Silverstein JH, Inouye SK, Marcantonio ER. Independent vascular and cognitive risk factors for postoperative delirium. Am J Med. 2007;120:807–13.PubMedCrossRef

23.

Ely EW, Inouye SK, Bernard GR, et al. Delirium in mechanically ventilated patients: validity and reliability of the confusion assessment method for the intensive care unit (CAM-ICU). JAMA. 2001;286:2703–10.PubMedCrossRef

24.

Francis J. Drug-induced delirium: diagnosis and treatment. Auckland: Mairangi Bay; 1996.

25.

Claassen J, Mayer SA, Kowalski RG, Emerson RG, Hirsch LJ. Detection of electrographic seizures with continuous EEG monitoring in critically ill patients. Neurology. 2004;62:1743–8.PubMed

26.

Jordan KG. Neurophysiologic monitoring in the neuroscience intensive care unit. Neurol Clin. 1995;13:579–626.PubMed

27.

Privitera M, Hoffman M, Moore JL, Jester D. EEG detection of nontonic-clonic status epilepticus in patients with altered consciousness. Epilepsy Res. 1994;18:155–66.PubMedCrossRef

28.

Vespa PM, O’Phelan K, Shah M, et al. Acute seizures after intracerebral hemorrhage: a factor in progressive midline shift and outcome. Neurology. 2003;60:1441–6.PubMed

29.

Towne AR, Waterhouse EJ, Boggs JG, et al. Prevalence of nonconvulsive status epilepticus in comatose patients. Neurology. 2000;54:340–5.PubMed

30.

Oddo M, Carrera E, Claassen J, Mayer SA, Hirsch LJ. Continuous electroencephalography in the medical intensive care unit. Crit Care Med. 2009;37:2051–6.PubMedCrossRef

31.

Alberts VP, Bos MJ, Koudstaal PJ, et al. Heart failure and the risk of stroke: the Rotterdam Study. Eur J Epidemiol. 2010;25:807–12.PubMedCrossRef

32.

Loh E, Sutton MS, Wun CC, et al. Ventricular dysfunction and the risk of stroke after myocardial infarction. N Engl J Med. 1997;336:251–7.PubMedCrossRef

33.

Trzepacz PT, Baker RW, Greenhouse J. A symptom rating scale for delirium. Psychiatry Res. 1988;23:89–97.PubMedCrossRef

34.

Benbadis SR, Sila CA, Cristea RL. Mental status changes and stroke. J Gen Intern Med. 1994;9:485–7.PubMedCrossRef

35.

Salerno D, Marik PE, Daskalakis C, Kolm P, Leone F. The role of head computer tomographic scans on the management of MICU patients with neurological dysfunction. J Intensive Care Med. 2009;24:372–5.PubMedCrossRef

36.

Morandi A, Gunther ML, Vasilevskis EE, et al. Neuroimaging in delirious intensive care unit patients: a preliminary case series report. Psychiatry (Edgmont). 2010;7:28–33.

37.

Warshaw G, Tanzer F. The effectiveness of lumbar puncture in the evaluation of delirium and fever in the hospitalized elderly. Arch Fam Med. 1993;2:293–7.PubMedCrossRef

38.

Inouye SK. Delirium in hospitalized older patients. Clin Geriatr Med. 1998;14:745–64.PubMed

39.

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;166:1338–44.PubMedCrossRef

40.

Pandharipande PP, Pun BT, Herr DL, et al. Effect of sedation with dexmedetomidine vs lorazepam on acute brain dysfunction in mechanically ventilated patients: the MENDS randomized controlled trial. JAMA. 2007;298:2644–53.PubMedCrossRef

41.

Riker RR, Shehabi Y, Bokesch PM, et al. Dexmedetomidine vs midazolam for sedation of critically ill patients: a randomized trial. JAMA. 2009;301:489–99.PubMedCrossRef

42.

Shehabi Y, Riker RR, Bokesch PM, Wisemandle W, Shintani A, Ely EW. Delirium duration and mortality in lightly sedated, mechanically ventilated intensive care patients. Crit Care Med. 2010;38:2311–8.PubMedCrossRef

43.

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;371:126–34.PubMedCrossRef

44.

Girard TD, Jackson JC, Pandharipande PP, et al. Delirium as a predictor of long-term cognitive impairment in survivors of critical illness. Crit Care Med. 2010;38:1513–20.PubMedCrossRef

45.

Adelow C, Andersson T, Ahlbom A, Tomson T. Prior hospitalization for stroke, diabetes, myocardial infarction, and subsequent risk of unprovoked seizures. Epilepsia. 2011;52(2):301–7.PubMed

46.

Caeiro L, Ferro JM, Claro MI, Coelho J, Albuquerque R, Figueira ML. Delirium in acute stroke: a preliminary study of the role of anticholinergic medications. Eur J Neurol. 2004;11:699–704.PubMedCrossRef

47.

Kress JP, Pohlman AS, O’Connor MF, Hall JB. Daily interruption of sedative infusions in critically ill patients undergoing mechanical ventilation. N Engl J Med. 2000;342:1471–7.PubMedCrossRef

48.

Schweickert WD, Pohlman MC, Pohlman AS, et al. Early physical and occupational therapy in mechanically ventilated, critically ill patients: a randomised controlled trial. Lancet. 2009;373:1874–82.PubMedCrossRef

49.

Strom T, Martinussen T, Toft P. A protocol of no sedation for critically ill patients receiving mechanical ventilation: a randomised trial. Lancet. 2010;375:475–80.PubMedCrossRef

50.

Yildizeli B, Ozyurtkan MO, Batirel HF, Kuscu K, Bekiroglu N, Yuksel M. Factors associated with postoperative delirium after thoracic surgery. Ann Thorac Surg. 2005;79:1004–9.PubMedCrossRef

51.

Krachman SL, D’Alonzo GE, Criner GJ. Sleep in the intensive care unit. Chest. 1995;107:1713–20.PubMedCrossRef

52.

Inouye SK, Baker DI, Fugal P, Bradley EH. Dissemination of the hospital elder life program: implementation, adaptation, and successes. J Am Geriatr Soc. 2006;54:1492–9.PubMedCrossRef

53.

Jacobi J, Fraser GL, Coursin DB, et al. Clinical practice guidelines for the sustained use of sedatives and analgesics in the critically ill adult. Crit Care Med. 2002;30:119–41.PubMedCrossRef

54.

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;104:21–6.PubMedCrossRef

55.

Mayer SA, Chong JY, Ridgway E, Min KC, Commichau C, Bernardini GL. Delirium from nicotine withdrawal in neuro-ICU patients. Neurology. 2001;57:551–3.PubMed

56.

Lucidarme O, Seguin A, Daubin C, et al. Nicotine withdrawal and agitation in ventilated critically ill patients. Crit Care. 2010;14:R58.

57.

Lee AH, Afessa B. The association of nicotine replacement therapy with mortality in a medical intensive care unit. Crit Care Med. 2007;35:1517–21.PubMedCrossRef

58.

Seder DB, Schmidt JM, Badjatia N, et al. Transdermal nicotine replacement therapy in cigarette smokers with acute subarachnoid hemorrhage. Neurocrit Care. 2011;14:77–83.PubMedCrossRef

59.

Adams F. Emergency intravenous sedation of the delirious, medically ill patient. J Clin Psychiatry. 1988;49(Suppl):22–7.PubMed

60.

Riker RR, Fraser GL, Cox PM. Continuous infusion of haloperidol controls agitation in critically ill patients. Crit Care Med. 1994;22:433–40.PubMedCrossRef

61.

Levenson JL. High-dose intravenous haloperidol for agitated delirium following lung transplantation. Psychosomatics. 1995;36:66–8.PubMed

62.

Sanders KM, Murray GB, Cassem NH. High-dose intravenous haloperidol for agitated delirium in a cardiac patient on intra-aortic balloon pump. J Clin Psychopharmacol. 1991;11:146–7.PubMedCrossRef

63.

Seneff MG, Mathews RA. Use of haloperidol infusions to control delirium in critically ill adults. Ann Pharmacother. 1995;29:690–3.PubMed

64.

Ray WA, Chung CP, Murray KT, Hall K, Stein CM. Atypical antipsychotic drugs and the risk of sudden cardiac death. N Engl J Med. 2009;360:225–35.PubMedCrossRef

65.

Schneider LS, Dagerman KS, Insel P. Risk of death with atypical antipsychotic drug treatment for dementia: meta-analysis of randomized placebo-controlled trials. JAMA. 2005;294:1934–43.PubMedCrossRef

66.

Wang PS, Schneeweiss S, Avorn J, et al. Risk of death in elderly users of conventional vs. atypical antipsychotic medications. N Engl J Med. 2005;353:2335–41.PubMedCrossRef

67.

Girard TD, Pandharipande PP, Carson SS, et al. Feasibility, efficacy, and safety of antipsychotics for intensive care unit delirium: the MIND randomized, placebo-controlled trial. Crit Care Med. 2010;38:428–37.PubMedCrossRef

68.

Devlin JW, Roberts RJ, Fong JJ, 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. 2009;38:419–27.CrossRef

69.

Lynch EP, Lazor MA, Gellis JE, Orav J, Goldman L, Marcantonio ER. The impact of postoperative pain on the development of postoperative delirium. Anesth Analg. 1998;86:781–5.PubMed

70.

Morrison RS, Magaziner J, Gilbert M, et al. Relationship between pain and opioid analgesics on the development of delirium following hip fracture. J Gerontol A Biol Sci Med Sci. 2003;58:76–81.PubMed

71.

Holbrook TL, Galarneau MR, Dye JL, Quinn K, Dougherty AL. Morphine use after combat injury in Iraq and post-traumatic stress disorder. N Engl J Med. 2010;362:110–7.PubMedCrossRef

72.

Komotar RJ, Mocco J, Ransom ER, et al. Herniation secondary to critical postcraniotomy cerebrospinal fluid hypovolemia. Neurosurgery. 2005;57:286–92. (discussion 92).PubMedCrossRef

73.

Brown CV, Zada G, Salim A, et al. Indications for routine repeat head computed tomography (CT) stratified by severity of traumatic brain injury. J Trauma. 2007;62:1339–44. (discussion 44–5).PubMedCrossRef

74.

Medical Research Council. Aids to the examination of the peripheral nervous system, Memorandum no. 45. London: Her Majesty’s Stationary Office; 1981.

Titel: Delirium and Sedation in the ICU
verfasst von: Jennifer A. Frontera
Publikationsdatum: 01.06.2011
Verlag: Humana Press Inc
Erschienen in: Neurocritical Care / Ausgabe 3/2011
Print ISSN: 1541-6933
Elektronische ISSN: 1556-0961
DOI: https://doi.org/10.1007/s12028-011-9520-0

Leitlinien kompakt für die Neurologie

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Neu im Fachgebiet Neurologie

23.04.2024 | Demenz | Nachrichten

Update Neurologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Delirium and Sedation in the ICU

Abstract

Leitlinien kompakt für die Neurologie

Neu im Fachgebiet Neurologie

Demenzkranke durch Antipsychotika vielfach gefährdet

Parkinson-Therapie im Wandel – aktuelle Leitlinie im Fokus

Auf diese Krankheiten bei Geflüchteten sollten Sie vorbereitet sein

Hustenstiller lindert Agitation bei Alzheimer

Update Neurologie

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 3/2011

Acute Ischemic Injury on Diffusion-Weighted Magnetic Resonance Imaging after Poor Grade Subarachnoid Hemorrhage

Acute Kidney Injury in Patients with Severe Traumatic Brain Injury: Implementation of the Acute Kidney Injury Network Stage System

Open-Label Randomized Trial of the Safety and Efficacy of a Single Dose Conivaptan to Raise Serum Sodium in Patients with Traumatic Brain Injury

In My Opinion: Serum Albumin Should be Maintained During Neurocritical Care

Spontaneous Intraventricular Hemorrhage Associated with Prolonged Diosmin Therapy

Locally-administered Intrathecal Thrombolytics Following Aneurysmal Subarachnoid Hemorrhage: A Systematic Review and Meta-analysis

Leitlinien kompakt für die Neurologie

Neu im Fachgebiet Neurologie

Demenzkranke durch Antipsychotika vielfach gefährdet

Parkinson-Therapie im Wandel – aktuelle Leitlinie im Fokus

Auf diese Krankheiten bei Geflüchteten sollten Sie vorbereitet sein

Hustenstiller lindert Agitation bei Alzheimer

Update Neurologie