ICU Delirium
Did you know that having an illness that requires a prolonged ICU stay, can lead to months of disability after discharge? As patients are grateful for overcoming a critical time in their lives, there is a high probability of having another difficult challenge ahead of them: not being able to function as they had been able to prior to their ICU stay. This may result from ICU delirium which affects 60% to 80% of patients that were on ventilators and 20% to 40% of patients that were not on ventilators (Brummel et al., 2014). In Nashville, Tennessee at St. Thomas Hospital, 126 ICU patients were studied between October 2003 and March 2006 and researchers found an association between the duration of ICU delirium and patients’ post ICU disability (Brummel et al., 2014). During the following year after discharge from the ICU, functional ability to perform activities of daily living (ADLs) were tested and the correlation of a longer period of ICU delirium and decreased ability to perform ADLs was found.
After watching three videos on ICU delirium and reading the article on this study, I agree with Dr. Brummel et al., that treatment of delirium is essential in attempt to prevent months of diminished motor function since performing one’s ADLs is of high importance to most individuals. This article also pointed out another interesting study that showed reduced delirium in ICU patients at risk of atrophy and weakness who received physical and occupational therapy (PT/OT) within the first couple of days while on a ventilator. It appears steps that need to be taken are assessment of ICU delirium, attempt to reduce the duration of ICU delirium, have PT/OT work with patients at risk in the ICU sooner rather than later, and continue to research ways to reduce disability post ICU discharge.
http://www.oapublishinglondon.com/images/html_figures/1301_572.jpg
References
Brummel N E Jackson J C Pandharipande P P Thompson J L Shintani A K Dittus R SGirard T D 2014 Delirium in the Intensive Care Unit subsequent long-term disability among survivors of mechanical ventilation.Brummel, N. E., Jackson, J. C., Pandharipande, P. P., Thompson, J. L., Shintani, A. K., Dittus, R. S.,…Girard, T. D. (2014). Delirium in the Intensive Care Unit subsequent long-term disability among survivors of mechanical ventilation. Crit Care Med, 42(2), 369-377. doi:10.1097/ccm.0b013e3182a645bd 201509211616561221419573
