RT Book, Section A1 Brummel, Nathan E. A1 Girard, Timothy D. A2 Hall, Jesse B. A2 Schmidt, Gregory A. A2 Kress, John P. SR Print(0) ID 1107721879 T1 Delirium in the Intensive Care Unit T2 Principles of Critical Care, 4e YR 2015 FD 2015 PB McGraw-Hill Education PP New York, NY SN 9780071738811 LK accesssurgery.mhmedical.com/content.aspx?aid=1107721879 RD 2024/03/29 AB Patients in the intensive care unit (ICU) who experience delirium are exhibiting an under-recognized form of organ dysfunction. Delirium is extremely common in ICU patients as factors such as comorbidity, the acute critical illness itself, and iatrogenesis intersect to create a high-risk setting for delirium. This neurologic complication is often hazardous, being associated with death, prolonged hospital stays, and long-term cognitive impairment and institutionalization. Neurologic dysfunction compromises patients’ ability to be removed from mechanical ventilation or to fully recover and regain independence. Unfortunately, health care providers in the ICU are unaware of delirium in many circumstances, especially those in which the patient's delirium is manifesting predominantly as the hypoactive (quiet) subtype rather than the hyperactive (agitated) subtype. Despite being often overlooked clinically, ICU delirium has increasingly been the subject of research during the past decade, which has brought to light the scope of the problem in critically ill patients and provided clinicians with tools for routinely monitoring delirium at the bedside. This chapter reviews the definition and salient features of delirium, its primary risk factors, including drugs associated with the development of delirium, proposed pathophysiologic mechanisms, validated methods for bedside delirium assessment, and nonpharmacologic and pharmacologic strategies for delirium management.