- Poster presentation
- Open Access
Delirium impact in a chronic ventilatory care unit
© BioMed Central Ltd 2006
- Published: 21 March 2006
- Clinical Practice Guideline
- Antipsychotic Drug
- Prospective Observational Study
- Insulin Dose
Delirium is a common but underdiagnosed and treated problem in the ICU. It has been associated with poor hospital outcomes, including increased morbidity and mortality, prolonged length of stay and functional decline. Recently published clinical practice guidelines from the Society of Critical Care Medicine recommended monitoring for the presence of delirium in all mechanically ventilated patients.
To compare the usual clinical assessment for delirium and the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU), to describe its characteristics in chronically ventilated patients and to evaluate the incidence, associated clinical conditions, use of antipsychotic drugs and late mortality.
A prospective observational study where delirium was evaluated on a daily basis and followed by a group of physicians and a nurse, previously trained. Thirty-five consecutive patients were admitted to the Ventilatory Care Unit (VCU) during a period of 9 mouths. Thirteen tracheotomized, mechanically ventilated, awake and cooperative subjects were included in the study protocol. Three of them returned to the VCU after discharge and were re-included, resulting in a total of 16 patients studied. The CAM-ICU tool was applied 5 days a week at same time in the afternoon and its data was compared with the physicians' and nurse's evaluation. The results are expressed as the mean ± SD. For statistical analysis we used the chi-square test for evaluated difference of proportion, and considered statistical significance as P < 0.05.
9.6 ± 5.5
7.5 ± 3.5
46.4 ± 29.7
40.3 ± 33.5
The incidence of delirium in this study was less than expected. CAM-ICU demonstrated inferior sensibility than that described in the literature. We could not demonstrate any difference between groups. The main limitation of this study was the low number of patients enrolled.