Delirium in the ICU

Abstract

Delirium is an important manifestation of CNS dysfunction in the ICU. Any change in mental status should not be attributed to "ICU psychosis". It is important to recognize the problem, appreciate the seriousness and rule out and treat life-threatening conditions that may result in delirium. Hypoactive delirium is difficult to diagnose, but it may be the initial or sole manifestation of a serious illness, such as sepsis, pneumonia, myocardial infarction or pulmonary embolism, especially in the elderly. Medications are the commonest causes of postoperative delirium. The CAM-ICU is a useful tool in diagnosing and monitoring delirium and should be used frequently in the ICU. Non-pharmacological methods of preventing and treating delirium must be tried and when necessary, hyperactive delirium may be controlled with intravenous haloperidol.