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Delirium in ICU
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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 4578

Special Issue Editors

Dr. Pedro Póvoa

E-Mail Website
Guest Editor
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
Prof. Dr. Jorge I. F. Salluh

E-Mail Website
Guest Editor
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
Prof. Dr. Felipe Dal-Pizzol

E-Mail Website
Guest Editor
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

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

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

Published Papers (3 papers)

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Research

15 pages, 603 KiB  
Article
Subsyndromal Delirium in Critically Ill Patients—Cognitive and Functional Long-Term Outcomes
by Maria Carolina Paulino, Catarina Conceição, Joana Silvestre, Maria Inês Lopes, Hernâni Gonçalves, Cláudia Camila Dias, Rodrigo Serafim, Jorge I. F. Salluh and Pedro Póvoa
J. Clin. Med. 2023, 12(19), 6363; https://doi.org/10.3390/jcm12196363 - 4 Oct 2023
Cited by 1 | Viewed by 973
Abstract
Subsyndromal delirium (SSD) in the Intensive Care Unit (ICU) is associated with an increased morbidity with unknown post-discharge functional and cognitive outcomes. We performed a prospective multicenter study to analyze the mental status of patients during their first 72 h after ICU admission [...] Read more.
Subsyndromal delirium (SSD) in the Intensive Care Unit (ICU) is associated with an increased morbidity with unknown post-discharge functional and cognitive outcomes. We performed a prospective multicenter study to analyze the mental status of patients during their first 72 h after ICU admission and its trajectory, with follow-ups at 3 and 6 months after hospital discharge. Amongst the 106 included patients, SSD occurred in 24.5% (n = 26) and was associated with the duration of mechanical ventilation (p = 0.003) and the length of the ICU stay (p = 0.002). After the initial 72 h, most of the SSD patients (30.8%) improved and no longer had SSD; 19.2% continued to experience SSD and one patient (3.8%) progressed to delirium. The post-hospital discharge survival rate for the SSD patients was 100% at 3 months and 87.5% at 6 months. At admission, 96.2% of the SSD patients were fully independent in daily living activities, 66.7% at 3-month follow-up, and 100% at 6-month follow-up. Most SSD patients demonstrated a cognitive decline from admission to 3-month follow-up and improved at 6 months (IQCODE-SF: admission 3.13, p < 0.001; 3 months 3.41, p = 0.019; 6 months 3.19, p = 0.194). We concluded that early SSD is associated with worse outcomes, mainly a transitory cognitive decline after hospital discharge at 3 months, with an improvement at 6 months. This highlights the need to prevent and identify this condition during ICU stays. Full article
(This article belongs to the Special Issue Delirium in ICU)
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10 pages, 742 KiB  
Article
Incidence Rate and Factors Associated with Delirium and Subsyndromal Delirium in Patients with COVID-19 in an Intensive Care Unit
by Lara Helena Perpetuo, Wellington Ferreira, Danilo Jorge da Silva, Mauro Eduardo Jurno and Thiago Cardoso Vale
J. Clin. Med. 2023, 12(11), 3789; https://doi.org/10.3390/jcm12113789 - 31 May 2023
Viewed by 1295
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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13 pages, 559 KiB  
Article
Effects of Melatonin Administration on Post-Stroke Delirium in Patients with Intracerebral Hemorrhage
by Vasileios Siokas, Sara Roesch, Maria-Ioanna Stefanou, Rebecca Buesink, Vera Wilke, Jennifer Sartor-Pfeiffer, Kamaldeen Adeyemi, Sven Poli, Efthimios Dardiotis, Ulf Ziemann, Katharina Feil and Annerose Mengel
J. Clin. Med. 2023, 12(5), 1937; https://doi.org/10.3390/jcm12051937 - 1 Mar 2023
Cited by 1 | Viewed by 1491
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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