Delirium in ICU patients - Screening, management and long-term outcomes (2020)

​Abstract

Background 
Delirium in the Intensive Care Unit (ICU), is common and has severe adverse outcomes for the patients. The overall aim of this thesis was to describe delirium management and long-term outcomes in ICU patients.

Method 
In two studies we explored clinician’s perception of delirium screening and management with qualitative methodology. And in two studies we investigated with observational designs the prevalence of antipsychotic use and cognitive impairment among ICU survivors.

Results
We found that professional role issue, instrument reliability and clinical consequence was the barriers for conducting delirium screening. We described that the decision to treat or not to treat delirium was based on delirium phenotype, the decision to act was based on experience or evidence, and the decision to intervene using nursing care or medications. We found that 46% of patients received haloperidol as treatment against delirium. We described that cognitive function was impaired in 52% of ICU survivors.

Conclusion 
This thesis describes that delirium detection still needs close attention and additional training of ICU clinicians. That delirium subtypes descries the part of interventions against delirium. That haloperidol was the most common antipsychotic used drug in ICU patients and that severe cognitive impairment in ICU su vivors was frequent.

Place of employment

PhD author

Marie Oxenboell Collet, cand.scient.san

Date and place of defense

17th June 2020, Graduate School of Health and Medical Science, Programme in Psychiatry, University of Copenhagen.

Supervisors

Professor Anders Perner (main)
Professor Ingrid Egerod
Associate Professor Thordis Thomsen
Medical Doctor Helle Nibro

Links

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