Special Issue "Delirium in ICU"

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Intensive Care".

Deadline for manuscript submissions: closed (20 March 2023) | Viewed by 2552

Special Issue Editors

1. NOVA Medical School, New University of Lisbon, Lisbon, Portugal
2. Center for Clinical Epidemiology and Research Unit of Clinical Epidemiology, OUH Odense University Hospital, Odense, Denmark
3. Hospital de São Francisco Xavier, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal
Interests: infection; sepsis; mechanical ventilation; pneumonia; intensive care units; biomarkers
1. Department of Critical Care and Postgraduate Program in Translational Medicine, D’Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
2. Programa de Pós-Graduação em Clínica Médica, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
Interests: infection; sedation; biomarkers; delirium; quality improvement
1. Graduate Program in Medical Sciences, Universidade do Extremo Sul Catarinense - Criciúma (SC), Brazil
2. Intensive Care Unit, Hospital São José, Criciúma, Brazil
Interests: infection; sepsis; biomarkers; delirium

Special Issue Information

Dear Colleagues,

Delirium is recognised as the most frequent and severe form of acute brain dysfunction in critically ill patients with sepsis. Delirium presents a wide range of manifestations and is associated with early and long-term consequences, such as increase in the length of stay, costs, mortality and cognitive impairment, generating high stress for the patient and relatives. Current interventions for its prevention involve early recognition, identification of modifiable risk factors and treatment of underlying conditions that predispose patients to delirium. Several specific pharmacologic interventions have been tested so far, with inconsistent results. Furthermore, nonpharmacologic interventions seem to be effective as preventive strategies. Considering your experience and expertise in this area, we hope that you will offer a scientific contribution to be published in this Special Issue.

Dr. Pedro Póvoa
Prof. Dr. Jorge I. F. Salluh
Prof. Dr. Felipe Dal-Pizzol
Guest Editors

Manuscript Submission Information

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Keywords

  • delirium
  • ICU
  • delirium treatment
  • delirium prevention
  • agitation
  • analgesia
  • critical care medicine
  • outcomes
  • protocols
  • sedation

Published Papers (2 papers)

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Research

Article
Incidence Rate and Factors Associated with Delirium and Subsyndromal Delirium in Patients with COVID-19 in an Intensive Care Unit
J. Clin. Med. 2023, 12(11), 3789; https://doi.org/10.3390/jcm12113789 - 31 May 2023
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Abstract
Background: Delirium subsyndrome (SSD) and delirium (DL) are known complications in the intensive care unit (ICU) and are associated with worse clinical outcomes. The aim of this study was to screen for SSD and DL in individuals with COVID-19 admitted to the ICU [...] Read more.
Background: Delirium subsyndrome (SSD) and delirium (DL) are known complications in the intensive care unit (ICU) and are associated with worse clinical outcomes. The aim of this study was to screen for SSD and DL in individuals with COVID-19 admitted to the ICU and to study the associated factors and clinical outcomes. Method: An observational, longitudinal study was conducted in the reference ICU for COVID-19. All admitted individuals with COVID-19 were screened for SSD and DL during their ICU stay using the Intensive Care Delirium Screening Checklist (ICDSC). Individuals with SSD and/or DL were compared to those without SSD and/or DL. Results: Ninety-three patients were evaluated, of which 46.7% had SSD and/or DL. The incidence rate was 4.17 cases/100 person-days. Individuals with SSD and/or DL had higher severity of illness on admission to the ICU, as measured by the APACHE II score (median 16 versus 8 points, p < 0.001). SSD and/or DL were associated with longer ICU and hospital stays (median 19 versus 6 days, p < 0.001 and median 22 versus 7 days, p < 0.001, respectively). Conclusion: Individuals with SSD and/or DL had greater disease severity and longer ICU and hospital stays when compared to those without SSD and/or DL. This reinforces the importance of screening for consciousness disorders in the ICU. Full article
(This article belongs to the Special Issue Delirium in ICU)
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Article
Effects of Melatonin Administration on Post-Stroke Delirium in Patients with Intracerebral Hemorrhage
J. Clin. Med. 2023, 12(5), 1937; https://doi.org/10.3390/jcm12051937 - 01 Mar 2023
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Abstract
Post-stroke delirium (PSD) after intracerebral hemorrhage (ICH) is considered to be even more detrimental compared to that after ischemic stroke. Treatment options for post-ICH PSD remain limited. This study aimed at investigating to what extent prophylactic melatonin administration may have beneficial effects on [...] Read more.
Post-stroke delirium (PSD) after intracerebral hemorrhage (ICH) is considered to be even more detrimental compared to that after ischemic stroke. Treatment options for post-ICH PSD remain limited. This study aimed at investigating to what extent prophylactic melatonin administration may have beneficial effects on post-ICH PSD. We performed a mono-centric, non-randomized, non-blinded, prospective cohort study, including 339 consecutive ICH patients admitted to the Stroke Unit (SU) from December 2015 to December 2020. The cohort consisted of ICH patients who underwent standard care (defined as the control group) and ICH patients who additionally received prophylactic melatonin (2 mg per day, at night) within 24 h of ICH onset until the discharge from the SU. The primary endpoint was post-ICH PSD prevalence. The secondary endpoints were: (i) PSD duration and (ii) the duration of SU stay. The PSD prevalence was higher in the melatonin treated cohort compared to the propensity score-matched (PSM) control group. Post-ICH PSD patients receiving melatonin had shorter SU-stay durations, and shorter PSD durations, although not statistically significant. This study shows no efficacy in limiting post-ICH PSD with preventive melatonin administration. Full article
(This article belongs to the Special Issue Delirium in ICU)
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