Delirium, a sudden onset and fluctuating cause of mental status often occurs in critical ill patients hospitalized in the ICU. Memory and language difficulty, disorientation, paranoid ideas are part of delirium with an increase in morbidity and mortality in the elderly (Svenningsen & Tonnesen, 2011). ICU delirium can be divided in hyperactive delirium with symptoms such as restlessness, aggression, and psychomotor hyperactivity. Hypoactive delirium portrays symptoms such as lethargic, and decreased psychomotor responds. Mixed delirium consist out of hyper-and hypoactive delirium. A study was performed in three ICU’s in Denmark with the goal to identify the correlation of delirium regarding analgesics, sedatives, opiods and age. Intubated and non-intubated patients participated in the study. In this particular study a correlation was detected between delirium and the length of stay in the ICU and an increase in mortality was observed in patients who died in the ICU with delirium. 40% of the patients in the ICU developed delirium. The usage of Fentanyl as an analgesic occurred to show also an increase in delirium. In order to reduce the incidence of delirium in the elderly it is important to manage cognitive impairment, immobility, and sleep deprivation, visual and hearing impairment.
Delirium is frightening experience for the patient and needs to be addressed immediately. It is interesting to read 40% of patients in ICU develop delirium, a concerning number. The article does not elaborate too much in the prevention of delirium which is disappointing. As nurses we are the patient’s advocates and have a unique role in the prevention and detection of delirium.
References
(Svenningsen H Tonnesen E 2011 Delirium incidents in three Danish intensive care units)Svenningsen, H., & Tonnesen, E. (2011). Delirium incidents in three Danish intensive care units. Nursing in critical care, 16(4), 186-192.