Factors causing acute delirium in critically ill adult patients: a systematic review.

Abstract

Review Question The primary focus of this systematic review is to synthesise the best available evidence on the factors which cause acute delirium in critically ill adult patients. More specifically, the objectives are to identify: 1) The factors which cause acute delirium in critically ill patients 2) Which factors are more likely to cause acute delirium in critically ill patients 3) What are the current preventive measures and treatment of delirium in critically ill patients 4) The short and long term consequences of delirium in critically ill patients Inclusion Criteria Types of Participants The review will consider studies that include adult patients in a critical care setting who: - present with acute delirium during their ICU stay; including hyperactive, hypoactive and mixed delirium - present with ICU psychosis, acute confusional state, ICU syndrome or other common terms17 linked to delirium This review excludes: 1) critically ill patients in general wards (in order to exclude factors that may be exclusive to the ICU); 2) critically ill patients in stepdown settings; 3) paediatric patients. iV as to exclude cases delirium that may confound due to differences in paediatric and adult physiology Types of Intervention(s)/Phenomena of Interest The review will consider studies that 1) examine the factors causing ICU delirium in critically ill adult patients, such as fever, hypoxia and sepsis; 2) examine current preventive measures and treatment of delirium in critically ill patients; 3) examine the short and long – term consequences of ICU delirium in critically ill patients. Types of Outcomes This review will consider studies that include the following outcome measures 1) the incidence and degree of severity of acute delirium as related to the individual factors; 2) the remission rates of acute delirium post treatment; 3) the short and long term consequences of ICU delirium, such as self care, memory and attention deficits.