RT Journal Article
T1 Diagnosis, prevention, and management of delirium in the intensive cardiac care unit
A1 Cortés Beringola, Alejandro
A1 Vicent, Lourdes
A1 Martín Asenjo, Roberto
A1 Puerto, Elena
A1 Domínguez Pérez, Laura
A1 Maruri, Ramón
A1 Moreno Muñoz, Guillermo
A1 Vidán Astiz, María Teresa
A1 Bueno Zamora, Héctor José
AB Delirium is a frequent complication in patients admitted to intensive cardiac care units (ICCU) with potentially severe consequences including increased risks of mortality, cognitive impairment and dependence at discharge, and longer times on mechanical ventilation and hospital stay. Delirium has been widely documented and studied in general intensive care units and in patients after cardiac surgery, but it has barely been studied in acute nonsurgical cardiac patients. Moreover, delirium (especially in its hypoactive form) is commonly misdiagnosed. We propose a protocol for delirium prevention and management in ICCUs. A daily comprehensive assessment to improve detection should be done using validated scales (ie, confusion assessment method). Preventive measures are particularly relevance and constitute the basis of treatment as well, acting on reversible risk factors, including environmental interventions, such as quiet time, sleep promotion, family support, communication, and adequate treatment of pain and dyspnea. Pharmacological prophylaxis is not indicated with the exception of patients at risk of withdrawal syndrome but should only be used in patients with confirmed delirium. Dexmedetomidine is the drug of choice in patients with severe agitation, and those weaning from invasive mechanical ventilation. As the complexity of ICCUs increases, clinical scenarios posing challenges for the management of delirium become more frequent. Efforts should be done to improve the identification of patients at risk during admission in order to establish preventive interventions to avoid this complication. Patient-centered protocols will increase the awareness of the healthcare professionals for better prevention and earlier diagnosis and will positively impact on prognosis.
PB Elsevier
SN 0002-8703
YR 2021
FD 2021-02
LK https://hdl.handle.net/20.500.14352/109563
UL https://hdl.handle.net/20.500.14352/109563
LA eng
NO Cortés-Beringola A, Vicent L, Martín-Asenjo R, Puerto E, Domínguez-Pérez L, Maruri R, et al. Diagnosis, prevention, and management of delirium in the intensive cardiac care unit. American Heart Journal. Mosby Inc.; 2021;232:164-76.
DS Docta Complutense
RD 10 abr 2025