Critical care delirium: prevention, identification and management: a narrative review
A comprehensive narrative review synthesizes the latest evidence on ICU delirium, a frequent and serious complication of critical illness affecting roughly one-third of patients. The analysis covers epidemiology, pathophysiology, and risk factors, highlighting the significant association between delirium and adverse outcomes like prolonged mechanical ventilation, extended hospital stays, and long-term cognitive issues. Crucially, the review finds that while pharmacological interventions show inconsistent benefits, effective prevention and management hinge on coordinated, non-pharmacological strategies. These multicomponent approaches—including optimal sedation, early mobilization, sleep hygiene, and family engagement—are linked to reduced incidence and improved functional recovery for patients.
Study Significance: For professionals focused on infectious diseases and infection control, this review underscores a critical, often overlooked sequela of severe infection and sepsis. Managing ICU delirium is a key component of comprehensive care for patients with severe bacterial infections or viral illnesses like influenza and COVID-19, where systemic inflammation and prolonged ICU stays are common. Implementing the recommended non-pharmacological bundles can directly improve patient outcomes and reduce the long-term burden of critical illness, making delirium prevention a strategic priority in antimicrobial stewardship and pandemic preparedness planning.
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