nursing401
Week 4 – ICU Delirium
This week for our research in regards to ICU delirium I found an article by Bathula and Gonzales (2013) titled “The Pharmacologic Treatment of Intensive Care Unit Delirium: A Systematic Review” from the Annals of Pharmacotherapy. Bathula & Gonzalez (2013) used a systematic analysis to discover different research studies that have been conducted in regards to pharmacotherapy and ICU delirium. Bathula & Gonzalez (2013) state that “treatment recommendations are conflicting” for ICU delirium (p. 1168). Bathula & Gonzalez’s (2013) research indicates studies attempting to compare the efficacy of specific antipsychotic medications versus placebos. Overall, Bathula & Gonzalez (2013) found no significant change in outcomes regardless of medication plan (p. 1172). Bathula & Gonzalez (2013) recommend that first-generation antipsychotics should not be used, but suggest that there appears to be some efficacy with second-generation antipsychotics. However, Bathula & Gonzalez (2013) highlight how the treatment of ICU delirium should focus “on the identification of the cause and risk factors and then modification of these causes,” (p. 1173).
After having read the article by Bathula & Gonzalez (2013), I agree that ICU delirium needs to be treated first by finding the sources and applying non-pharmacological methods as much as possible. In addition, I found it interesting that with the placebo groups that were allowed to use “rescue meds” (ex: sedatives for agitation), that there was no change in outcomes between study groups. Suggesting that there is no benefit to the use of antipsychotic medications for ICU delirium. But in saying this, every case needs to be treated on a case by case basis. Bathula & Gonzalez (2013) highlight how there are different types of ICU delirium and may require different plans of treatment. Overall, Bathula & Gonzalez’s (2013) article was very informative on current pharmacological approaches being considered for the treatment of ICU delirium.
Bathula, M. & Gonzalez, J. (2013). The Pharmacologic Treatment of Intensive Care Unit Delirium: A Systematic Review. Annals of Pharmacotherapy, 47(9), 1168-1174. doi: 10.1177/1060028013500466
