Delirium in I.C.U

Delirium (delirium in Anglo-Saxon literature) or acute confusional syndrome is a serious organic neuropsychiatric disorder. It is the most frequent manifestation of acute central nervous system (CNS) dysfunction, occurring in up to 80% of patients admitted to the Intensive Care Unit (ICU). But unlike other dysfunctions, it is not recognized by intensivists as a common multi-organ dysfunction. It is an underdiagnosed entity, undervalued and undertreated. Delirium is an independent predictor of mortality, prolonged length of hospital stay, long-term cognitive impairment and high health costs.

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The practices of the ICU health team influence the incidence of delirium and its consequences, therefore, efforts should be made to understand what aspects of delirium are predictable, preventable, detectable and treatable.

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Delirium reflects the disorganization of cognition, thus one or more of the previous domains are altered determining behavioral symptoms. 

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Delirium diagnosis is based on the criteria defined by the American Psychiatric Association in the 5th version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V). The tools most commonly use for its detection in the critical patient with invasive mechanical ventilation (IMV) are: the CAM-ICU (Confusion Assessment Method for the Intensive Care Unit) and the criteria for the detection of delirium in intensive care or IC- DSC (Intensive Care Delirium Screening Checklist) developed in English in the United States and Canada, respectively.