Delirium in the ICU - A structured review of promising diagnostic and therapeutic approaches: Next steps in ICU delirium
2020
Background: The purpose of this review is to provide a
structured overview of emerging diagnostic and therapeutic
modalities for delirium in critically ill patients.
Methods: Literature searches were carried out to identify relevant
articles for both diagnostic and therapeutic approaches other than
those included in the 2018 Pain, Agitation/Sedation, Delirium,
Immobility, and Sleep Disruption in Adult Patients in the ICU
guidelines, including prospective and retrospective studies.
Results: Regarding diagnostic approaches seven articles were
included. The Neelon and Champagne (NEECHAM) Confusion
Scale, Stanford Proxy Test for Delirium (S-PTD), and DelAppICU yielded excellent diagnostic performances. We included
seven articles studying different therapies. Some therapies
showed potential to decrease the burden of delirium, using
different pathophysiological pathways than antipsychotics.
Conclusion: Alternative screening tools may help in ICU
delirium detection, either as replacement or combined with
the Confusion Assessment Method for ICU (CAM-ICU)
and Intensive Care Delirium Screening Checklist (ICDSC),
and other therapies than antipsychotics may reduce delirium
burden, but further studies are required.
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