Delirium in Critical Care (Core Critical Care)

Delirium is a common clinical problem in critical care patients, with up to 80% of patients experiencing at least one episode during their time on a critical care unit. It is associated with significantly adverse outcomes for patients, including death and long-term cognitive impairment equivalent to at least a mild dementia. This clinical handbook explains why delirium goes unrecognised in most ICUs and describes simple tools the bedside clinician can use to detect it, even in the ventilated patient. It is in an easy-to-read format and illustrated with figures, case reports and patient testimony. This book contains all you need to know in order to prevent, diagnose and manage delirium in your patients. Delirium in Critical Care is essential reading for all members of the intensive care multidisciplinary team, including senior and junior physicians, and nurses.

Table of Contents

Foreword
Part I. What is Delirium in Critical Care?: 1. Delirium as acute brain failure
2. DSM IV criteria
3. History
4. Terminology in critical care
Part II. Delirium in Critical Care - How Common Is It?: 5. Incidence and prevalence in different critical care populations
6. Duration
Part III. Delirium in Critical Care - What Does It Look Like?: 7. Hyperactive, hypoactive, mixed motoric subtypes
8. Clinical examples
Part IV. Delirium in Critical Care - How Does It Happen?: 9. Pathophysiology, including theories for septic encephalopathy, cortisol, modulation immune system
Part V. Delirium in Critical Care - What Causes It?: 10. Risk factors, predisposing and precipitating
Part VI. Delirium in Critical Care - Why Is It Important?: 11. Adverse outcomes
12. Independent predictor mortality
13. Association with long-term cognitive impairment
14. Diagnosing new morbidity in patients
15. Impact on relatives and family
Part VII. Delirium in Critical Care - How Do We Diagnose It?: 16. Screening tools, CAM-ICU, ICDSC and even NEECHAM (not useful in intubated patients)
Part VIII. Delirium in Critical Care - How Do We Prevent It?: 17. Multi-component interventions to minimise predisposing risk factors
18. Drugs used for sedation
Part IX. Delirium in Critical Care - How Do We Treat It?: 19. Identifying and treating precipitating cause
20. Antipsychotics
21. Do we need to involve a psychiatrist?
Part X. Delirium in Critical Care and the Law: 22. Mental capacity and ability to make choices
23. End of life care in delirious patients
Part XI. Delirium in Critical Care - What's Its Future In Critical Care?: 24. Routine screening in ICUs, early management
25. New ways of giving old sedative drugs, new drugs
26. Research into whether treating delirium, decreasing duration improves outcomes
27. Follow up cognitive assessment
Index.