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