X-Message-Number: 26635 Date: Sat, 16 Jul 2005 13:12:09 +0200 From: Eugen Leitl <> Subject: [: [ccm-l] Delirium: acute cognitive dysfunction in the critically ill.] ----- Forwarded message from Eric Hodgson <> ----- From: Eric Hodgson <> Date: Sat, 16 Jul 2005 07:27:32 +0200 To: Subject: [ccm-l] Delirium: acute cognitive dysfunction in the critically ill. X-mailer: Pegasus Mail for Windows (4.21c) Reply-To: Eric Hodgson <> Delirium: acute cognitive dysfunction in the critically ill. Current Opinion in Critical Care. 11(4):360-368, August 2005. Pandharipande, Pratik a; Jackson, James b; Ely, E Wesley b,c Abstract: Purpose of review: The management of sepsis and the multiple organ dysfunction syndrome has traditionally been centered on dysfunction of organs other than the brain (e.g., heart, lungs, or kidneys), although the brain is one of the most prevalent organs involved. Recent studies indicate that nonpulmonary acute organ dysfunction may contribute significantly to mortality and other important clinical outcomes. Acute confusional states (delirium) occur in 10 to 60% of the older hospitalized population and in 60 to 80% of patients in the intensive care unit, yet go unrecognized by the managing physicians and nurses in 32 to 66% of cases. Delirium is an important independent prognostic determinant of hospital outcomes, including duration of mechanical ventilation, nursing home placement, functional decline, and death. Recently, new monitoring instruments have been validated for monitoring of delirium in noncommunicative patients receiving mechanical ventilation. Hence, critical care physicians and nurses should routinely assess their patients for delirium and develop strategies for its prevention and treatment. Recent findings: This state-of-the-art review discusses in depth the delirium monitoring instruments, the pathophysiology and risk factors of delirium, its prognostic implications, and strategies (including ongoing clinical trials) to prevent and treat delirium. Summary: Delirium is extremely common and has significant prognostic implications in critically ill patients. Routine monitoring and a multimodal approach to prevent or reduce the prevalence of delirium are of paramount importance. ----- End forwarded message ----- -- Eugen* Leitl <a href="http://leitl.org">leitl</a> ______________________________________________________________ ICBM: 48.07100, 11.36820 http://www.leitl.org 8B29F6BE: 099D 78BA 2FD3 B014 B08A 7779 75B0 2443 8B29 F6BE Rate This Message: http://www.cryonet.org/cgi-bin/rate.cgi?msg=26635