ICU Delirium

According to Vanderbilt University (2013), delirium is the inattention and confusion that presents like the brain is temporarily failing.  Delirium is a common problem in the ICU and 7/10 critical patients usually experience it (Vanderbilt University, 2013).  Patients who are on sedation, older, cognitively impaired, recovering from surgery, septic, or suffering from heart failure have been found to be more susceptible to developing delirium in the ICU.  It appears to be caused by lack of oxygen to the brain, medications, infections, pain, and other chemical changes in the brain.  If not identified and cared for, delirium can cause lasting cognitive impairment, post-traumatac stress disorder (PTSD), and depression (Vanderbilt University, 2013).  To prevent or treat ICU delirium, the care providers should continuously reorient patients, provide stimulating activities, mobilize patients early, treat their pain, reduce noise and stimuli, and provide sedation vacations (Vanderbilt University, 2013).  It is important for nurses to assess their sedated patients for delirium because early recognition can prevent a lifetime of psychological distress.

The article titled, “Sedation and Its Psychological Effects Following Intensive Care,” reviews and explores the relationship between sedation and psychological disorders after recover and discharge from the ICU.  The review of literature found that lighter sedation reduced the length of stay in ICU and length of time on mechanical ventilation.  However, lighter sedation generally did not reduce the outcomes of PTSD and more research is needed to identify more specific relationships between sedation and psychological distress (Croxall, Tyas, & Garside, 2014). More research should be done on the specific psychological effects of sedation and ICU delirium.  Also, more research could be done on the specific types of sedation and which ones are the most psychologically impairing.  I found that ICU stays can be shorted with lighter doses of sedation to be very interesting.  This means that patients can wean from mechanical ventilation earlier and recover in a faster amount of time, which is beneficial to both the patients and care providers.

References

Croxall, C., Tyas, M., & Garside, J.  (2014).  Sedation and its psychological effects following intensive care.  British Journal of Nursing, 23.  Retrieved from http://web.b.ebscohost.com.summit.csuci.edu:2048/ehost/detail/detail?vid=3&sid=522b8a73-3c8f-4f87-9893-e2ba89b4bbe4%40sessionmgr114&hid=101&bdata=JnNpdGU9ZWhvc3QtbGl2ZQ%3d%3d#db=rzh&AN=2012702846

Vanderbilt University.  (2013).  ICU  delirium and cognitive impairment.  Retrieved from http://www.icudelirium.org/index.html