Intensive Care Unit Delirium: A Review of Diagnosis, Prevention, and Treatment

Anesthesiology. 2016 Dec;125(6):1229-1241. doi: 10.1097/ALN.0000000000001378.

Abstract

A 77 year-old male is admitted to the hospital after sustaining a hip fracture. He has a past medical history of chronic obstructive pulmonary disease, hypertension, hyperlipidemia, chronic back pain, and hearing loss. Prior to surgery he receives midazolam for agitation and morphine for pain control. He undergoes a general anesthetic for his fracture repair, requiring high doses of fentanyl for pain control. Postoperatively, he has poor pulmonary mechanics and is taken to the ICU intubated and mechanically ventilated. On postoperative day one, his sedation is weaned and he is put on a spontaneous breathing trial. While he appears intermittently awake, he will not follow commands and only intermittently makes eye contact. The patient is left intubated due to his altered mental status.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Critical Care / methods*
  • Delirium / diagnosis*
  • Delirium / prevention & control
  • Delirium / therapy*
  • Humans
  • Intensive Care Units*