Delirium in the intensive care unit and its importance in the post-operative context: A review
The burden of delirium in the intensive care setting is a global priority. Delirium affects up to 80% of patients in intensive care units; an episode of delirium is often distressing to patients and their families, and delirium in patients within, or outside of, the intensive care unit (ICU) setting...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-03-01
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| Series: | Frontiers in Medicine |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2023.1071854/full |
| _version_ | 1797856195783950336 |
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| author | Danielle Ní Chróinín Danielle Ní Chróinín Evan Alexandrou Evan Alexandrou Evan Alexandrou Steven A. Frost Steven A. Frost |
| author_facet | Danielle Ní Chróinín Danielle Ní Chróinín Evan Alexandrou Evan Alexandrou Evan Alexandrou Steven A. Frost Steven A. Frost |
| author_sort | Danielle Ní Chróinín |
| collection | DOAJ |
| description | The burden of delirium in the intensive care setting is a global priority. Delirium affects up to 80% of patients in intensive care units; an episode of delirium is often distressing to patients and their families, and delirium in patients within, or outside of, the intensive care unit (ICU) setting is associated with poor outcomes. In the short term, such poor outcomes include longer stay in intensive care, longer hospital stay, increased risk of other hospital-acquired complications, and increased risk of hospital mortality. Longer term sequelae include cognitive impairment and functional dependency. While medical category of admission may be a risk factor for poor outcomes in critical care populations, outcomes for surgical ICU admissions are also poor, with dependency at hospital discharge exceeding 30% and increased risk of in-hospital mortality, particularly in vulnerable groups, with high-risk procedures, and resource-scarce settings. A practical approach to delirium prevention and management in the ICU setting is likely to require a multi-faceted approach. Given the good evidence for the prevention of delirium among older post-operative outside of the intensive care setting, simple non-pharmacological interventions should be effective among older adults post-operatively who are cared for in the intensive care setting. In response to this, the future ICU environment will have a range of organizational and distinct environmental characteristics that are directly targeted at preventing delirium. |
| first_indexed | 2024-04-09T20:36:28Z |
| format | Article |
| id | doaj.art-26373c433fe54eaf81fe9b1073af39e8 |
| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-04-09T20:36:28Z |
| publishDate | 2023-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Medicine |
| spelling | doaj.art-26373c433fe54eaf81fe9b1073af39e82023-03-30T08:03:46ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2023-03-011010.3389/fmed.2023.10718541071854Delirium in the intensive care unit and its importance in the post-operative context: A reviewDanielle Ní Chróinín0Danielle Ní Chróinín1Evan Alexandrou2Evan Alexandrou3Evan Alexandrou4Steven A. Frost5Steven A. Frost6Liverpool Hospital, Liverpool, NSW, AustraliaSouth Western Sydney Clinical School, UNSW Sydney, Liverpool, NSW, AustraliaLiverpool Hospital, Liverpool, NSW, AustraliaSouth Western Sydney Clinical School, UNSW Sydney, Liverpool, NSW, AustraliaCentre for Applied Nursing Research, School of Nursing and Midwifery, Western Sydney University and Ingham Institute of Applied Medical Research, Liverpool, NSW, AustraliaSchool of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, AustraliaSWS Nursing and Midwifery Research Alliance, Ingham Institute of Applied Medical Research, Liverpool, NSW, AustraliaThe burden of delirium in the intensive care setting is a global priority. Delirium affects up to 80% of patients in intensive care units; an episode of delirium is often distressing to patients and their families, and delirium in patients within, or outside of, the intensive care unit (ICU) setting is associated with poor outcomes. In the short term, such poor outcomes include longer stay in intensive care, longer hospital stay, increased risk of other hospital-acquired complications, and increased risk of hospital mortality. Longer term sequelae include cognitive impairment and functional dependency. While medical category of admission may be a risk factor for poor outcomes in critical care populations, outcomes for surgical ICU admissions are also poor, with dependency at hospital discharge exceeding 30% and increased risk of in-hospital mortality, particularly in vulnerable groups, with high-risk procedures, and resource-scarce settings. A practical approach to delirium prevention and management in the ICU setting is likely to require a multi-faceted approach. Given the good evidence for the prevention of delirium among older post-operative outside of the intensive care setting, simple non-pharmacological interventions should be effective among older adults post-operatively who are cared for in the intensive care setting. In response to this, the future ICU environment will have a range of organizational and distinct environmental characteristics that are directly targeted at preventing delirium.https://www.frontiersin.org/articles/10.3389/fmed.2023.1071854/fulldeliriumpost-operativeintensive care unitnursingmultidisciplinarycognitive impairment |
| spellingShingle | Danielle Ní Chróinín Danielle Ní Chróinín Evan Alexandrou Evan Alexandrou Evan Alexandrou Steven A. Frost Steven A. Frost Delirium in the intensive care unit and its importance in the post-operative context: A review Frontiers in Medicine delirium post-operative intensive care unit nursing multidisciplinary cognitive impairment |
| title | Delirium in the intensive care unit and its importance in the post-operative context: A review |
| title_full | Delirium in the intensive care unit and its importance in the post-operative context: A review |
| title_fullStr | Delirium in the intensive care unit and its importance in the post-operative context: A review |
| title_full_unstemmed | Delirium in the intensive care unit and its importance in the post-operative context: A review |
| title_short | Delirium in the intensive care unit and its importance in the post-operative context: A review |
| title_sort | delirium in the intensive care unit and its importance in the post operative context a review |
| topic | delirium post-operative intensive care unit nursing multidisciplinary cognitive impairment |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2023.1071854/full |
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