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ICU Delirium and ICU-related PTSD
Annachiara Marra, MD, PhD(c), Pratik P. Pandharipande, MD, MSCI, FCCM, and Mayur B. Patel, MD, MPH, FACS
Surgical Clinics of North America
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Critical Care Physicians, Nurses and/or Other Critical Care Medical Professionals
Delirium is one of the most common behavioral manifestations of acute brain dysfunction in Intensive Care Unit (ICU) and is a strong predictor of worse outcome. Routine monitoring for delirium is recommended for all ICU patients using validated tools (e.g., CAM-ICU, ICDSC). In delirious patients, a search for all reversible precipitants is the first line of action and pharmacological treatment should be considered when all causes have been ruled out, and not contraindicated. Long-term morbidity, in the forms of cognitive, physical and psychological impairments, has significant consequences for survivors of critical illness and for their caregivers. ICU patients may develop PTSD anchored to their critical illness experience, with ICU-related PTSD incidence rates of 10%. Using ICU diaries during a critical illness may minimize the occurrence of future ICU-related PTSD.
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