Disease Management in Patients with Delirium

Abstract

Delirium occurs as a pathophysiological state in connection with various diseases, particularly among patients in critical care. Since it may be a life-threatening condition, any physician should be able to initiate correct assessment and treatment of delirium. This review summarizes current knowledge on care of patients with delirium. The symptoms of delirium contain primarily disturbance of consciousness, attention, cognition, and perception and may comprise disturbance of psychomotor activity, emotions, and sleep. High prevalence of delirium is observed in critically ill patients in intensive care units. It is thus necessary to monitor the comorbid conditions when patients are diagnosed with delirium, especially since delirium is a prognostic factor for rise in morbidity and mortality. The identification of underlying aetiology of delirium and immediate intervention and treatment for urgent general medical conditions should be in the focus, and should be paralleled by measures ensuring patient's safety and continuous monitoring. Somatic interventions depend on underlying aetiology, and patient's clinical as well as comorbid conditions, but they mainly consist of treatment with high-potency neuroleptic drugs such as haloperidol. Interventions which reduce or eliminate environmental factors contributing to an exacerbation and maintenance of delirium are strongly recommended. Eventually, it is important to establish and maintain psychological support to the patient and his family regarding illness, including post-delirium management.