This article is part of the supplement: Analgesia and sedation in the intensive care unit .

Review

Delirium in the intensive care unit

Timothy D Girard^1,2 , Pratik P Pandharipande³ and E Wesley Ely^1,2,4

¹Department of Medicine; Division of Allergy, Pulmonary, and Critical Care Medicine; Vanderbilt University School of Medicine; 1161 21st Avenue South, Nashville, TN 37232-2650, USA

²Center for Health Services Research; Vanderbilt University School of Medicine; 1215 21st Avenue South, Nashville, TN 37232-8300, USA

³Department of Anesthesiology; Division of Critical Care; Vanderbilt University School of Medicine; 1215 21st Avenue South, Nashville, TN 37212-1120, USA

⁴Veterans Affairs Tennessee Valley Geriatric Research, Education, and Clinical Center; 1310 24th Avenue South, Nashville, TN 37212-2637, USA

author email corresponding author email

Critical Care 2008, 12(Suppl 3):S3doi:10.1186/cc6149

Published:	14 May 2008

Abstract

Delirium, an acute and fluctuating disturbance of consciousness and cognition, is a common manifestation of acute brain dysfunction in critically ill patients, occurring in up to 80% of the sickest intensive care unit (ICU) populations. Critically ill patients are subject to numerous risk factors for delirium. Some of these, such as exposure to sedative and analgesic medications, may be modified to reduce risk. Although dysfunction of other organ systems continues to receive more clinical attention, delirium is now recognized to be a significant contributor to morbidity and mortality in the ICU, and it is recommended that all ICU patients be monitored using a validated delirium assessment instrument. Patients with delirium have longer hospital stays and lower 6-month survival than do patients without delirium, and preliminary research suggests that delirium may be associated with cognitive impairment that persists months to years after discharge. Little evidence exists regarding the prevention and treatment of delirium in the ICU, but multicomponent interventions reduce the incidence of delirium in non-ICU studies. Strategies for the prevention and treatment of ICU delirium are the subjects of multiple ongoing investigations.