Delirium In the ICU

What does DSM (as in DAM-IV) stand for?

Diagnostic and Statistical Manual of Mental Disorders .

What are consequences of untreated pain in ICU?

• Short term: Higher energy expenditure and immunomodulation

• Long Term: PTSD

What are the best available Pain Scale utilised in icu?

• CPOT- Critical care pain observational tool

• Behavioural pain scale

What are the few indications for continuous deep sedation?

• Intracranial hypertension

• Refractory status epilepticus

• Prevention of awareness in pts requiring muscle paralysis

• Severe respiratory failure

What type of drug is Dexmetetomidine and what are its advantages?

• Alpha adrenergic receptor agonists

• Produces analgesia, less resp depression , allows pt to be more interactive and communicate their needs.

• It is a sedative used in the ICU for its sedative properties without significant respiratory depression, facilitating patient communication and participation in care.

What are the 4 domains of Delirium? and which is considered the cardinal domain?

• Acute Change in Mental Status with Fluctuating Course

• Inattention

• Disorganised Thinking

• Altered Level of Consciousness

IDAA

Define Delirium.

Sudden severe confusion and rapid changes in brain function that occur with physical or mental illness.

There is no agreed upon pathophysiology of Delirium in association with critical illness, what are some prescribed risk factors?

• GABA Type A agonist

• Anticholinergic drugs

• Dopaminergic activity

• Neurotoxic effects of inflam cytokines.

What are the risk factors of delirium?

• Advance age

• Presence of one or more condition associated with coma

• treatment with sedative drugs

• A Neurologic dx

• Severe illness

What are the types of delirium?

• Hypoactive

• Hyperactive

• mixed

what are the difference between Hypoactive vs hyperactive delirium

What is the target Richmond Agitation Sedation Scale in the mechanically ventilated patient?

• -2 to 0