Diagnosis, Prevention, and Management of Delirium in the ICU

Delirium is a frequent yet underrecognized complication in the ICU that is characterized by fluctuating disturbances in cognition and consciousness. Rapid identification, investigation of possible etiologies, and management of this syndrome is essential, as it has serious immediate and long-term consequences for patients, including increased mortality, longer hospital stays, and possible latent cognitive impairments. Prevention of delirium includes nonpharmacologic interventions such as daily awakenings, early mobilization, and careful choice of sedatives. Management of delirium includes numerous nonpharmacologic environmental measures such as frequent reorientation, minimizing interventions, and removal of restraints, as well as treatment of the underlying etiology. Medical management, which includes management of symptoms with medications such as antipsychotics, is likely overused. Further research is critical to delineate ideal methods in prevention and treatment of this disorder.