Delirium in intensive care unit

Abstract

The  most common cause of behavioural disturbances in the Intensive Care Unit (/CU) is the de­ lirium. Its manifestations are: fluctuation of the state of awareness, disturbance of the sleep­ awake cyde, deficit of attention and concentrati­on, disorganized thought that originates incohe­rent speech, disturbances of perception like illu­sions and/or hallucinations, disorientation in time and space, agitation or reduced psychomo­tor activity and disturbed memory. The major causes of delirium in the /CU are: systemic and metabolic diseases, for instance sepsis, renal fai­lure and hepatic failure; exogenous toxic agents, e.g. some drugs; withdrawal from substances upon which the patient has become dependent, like alcohol; and primary intracranial diseases such as infections of the central nervous system. Other factors often coexist like sleep deprivati­on, previous cognitive deficits, fear, anxiety and the patient's personality. Treatment comprises the correction of metabolic and systemic disturban­ces, the suspension of toxics and/or the use of antidotes, the withdrawal treatment, the use of haloperidol and benzodiazepines, and non-phar­ macological actions that reduce the environmen­tal stress and promote the physical and mental well-being.