Delirium in trauma ICUs: a review of incidence, risk factors, outcomes, and management.
Journal
Current opinion in anaesthesiology
ISSN: 1473-6500
Titre abrégé: Curr Opin Anaesthesiol
Pays: United States
ID NLM: 8813436
Informations de publication
Date de publication:
01 Apr 2023
01 Apr 2023
Historique:
pubmed:
7
1
2023
medline:
25
2
2023
entrez:
6
1
2023
Statut:
ppublish
Résumé
This article reviews the impact and importance of delirium on patients admitted to the ICU after trauma, including the latest work on prevention and treatment of this condition. As the population ages, the incidence of geriatric trauma will continue to increase with a concomitant rise in the patient and healthcare costs of delirium in this population. Recent studies have further defined the risk factors for delirium in the trauma ICU patient population, as well as better demonstrated the poor outcomes associated with the diagnosis of delirium in these patients. Recent trials and meta-analysis offer some new evidence for the use of dexmedetomidine and quetiapine as preferred agents for prevention and treatment of delirium and add music interventions as a promising part of nonpharmacologic bundles. Trauma patients requiring admission to the ICU are at significant risk of developing delirium, an acute neuropsychiatric disorder associated with increased healthcare costs and worse outcomes including increased mortality. Ideal methods for prevention and treatment of delirium are not well established, especially in this population, but recent research helps to clarify optimal prevention and treatment strategies.
Identifiants
pubmed: 36607823
doi: 10.1097/ACO.0000000000001233
pii: 00001503-202304000-00005
doi:
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
137-146Informations de copyright
Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Références
Prin M, Li G. Complications and in-hospital mortality in trauma patients treated in intensive care units in the United States, 2013. Inj Epidemiol 2016; 3:18.
Marquetand J, Gehrke S, Bode L, et al. Delirium in trauma patients: a 1-year prospective cohort study of 2026 patients. Eur J Trauma Emerg Surg 2022; 48:1017–1024.
Stollings JL, Kotfis K, Chanques G, et al. Delirium in critical illness: clinical manifestations, outcomes, and management. Intensive Care Med 2021; 47:1089–1103.
Rahimi-Bashar F, Abolhasani G, Manouchehrian N, et al. Incidence and risk factors of delirium in the intensive care unit: a prospective cohort. BioMed Res Int 2021; 2021:1–9.
Dziegielewski C, Skead C, Canturk T, et al. Delirium and associated length of stay and costs in critically ill patients. Crit Care Res Pract 2021; 2021:1–8.
Terrando N, Akassoglou K. Breaking barriers in postoperative delirium. Br J Anaesth 2022; 129:147–150.
Ní Chróinín D, Francis N, Wong P, et al. Older trauma patients are at high risk of delirium, especially those with underlying dementia or baseline frailty. Trauma Surg Acute Care Open 2021; 6:e000639.
DiMaggio CJ, Avraham JB, Lee DC, et al. The epidemiology of emergency department trauma discharges in the United States. Acad Emerg Med 2017; 24:1244–1256.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders [Internet]. Fifth Edition. American Psychiatric Association; 2013.
Poulsen LM, Estrup S, Mortensen CB, Andersen-Ranberg NC. Delirium in intensive care. Curr Anesthesiol Rep 2021; 11:516–523.
Shoulders BR, Elsabagh S, Tam DJ, et al. Risk factors for delirium and association of antipsychotic use with delirium progression in critically ill trauma patients. Am Surg 2022; DOI: 10.1177/00031348211069792. [Online ahead of print].
doi: 10.1177/00031348211069792.
Fong TG, Tulebaev SR, Inouye SK. Delirium in elderly adults: diagnosis, prevention and treatment. Nat Rev Neurol 2009; 5:210–220.
Roberson SW, Patel MB, Dabrowski W, et al. Challenges of delirium management in patients with traumatic brain injury: from pathophysiology to clinical practice. Curr Neuropharmacol 2021; 19:1519–1544.
Poignant S, Vigué B, Balram P, et al. ANARLF and AtlanRea Network for the SEDABIP ICU Study. A one-day prospective national observational study on sedation-analgesia of patients with brain injury in French Intensive Care Units: the SEDA-BIP-ICU (Sedation-Analgesia in Brain Injury Patient in ICU) Study. Neurocrit Care 2022; 36:266–278.
O’Connell KM, Patel KV, Powelson E, et al. Use of regional analgesia and risk of delirium in older adults with multiple rib fractures: an Eastern Association for the Surgery of Trauma multicenter study. J Trauma Acute Care Surg 2021; 91:265–271.
Abdelrahman I, Vieweg R, Irschik S, et al. Development of delirium: association with old age, severe burns, and intensive care. Burns 2020; 46:797–803.
Stanley GHM, Barber ARJ, O’Brien AM, et al. Delirium in hospitalised adults with acute burns - a systematic review. Burns 2022; 48:1040–1054.
Angles EM, Robinson TN, Biffl WL, et al. Risk factors for delirium after major trauma. Am J Surg 2008; 196:864–870.
Bryczkowski SB, Lopreiato MC, Yonclas PP, et al. Risk factors for delirium in older trauma patients admitted to the surgical intensive care unit. J Trauma Acute Care Surg 2014; 77:944–951.
Zaal IJ, Devlin JW, Peelen LM, Slooter AJ. A systematic review of risk factors for delirium in the ICU. Crit Care Med 2015; 43:40–47.
Duceppe MA, Williamson DR, Elliott A, et al. Modifiable risk factors for delirium in critically ill trauma patients: a multicenter prospective study. J Intensive Care Med 2019; 34:330–336.
Von Rueden KT, Wallizer B, Thurman P, et al. Delirium in trauma patients: prevalence and predictors. Crit Care Nurse 2017; 37:40–48.
Janssen TL, Hosseinzoi E, Vos DI, et al. The importance of increased awareness for delirium in elderly patients with rib fractures after blunt chest wall trauma: a retrospective cohort study on risk factors and outcomes. BMC Emerg Med 2019; 19:34.
Pandharipande P, Cotton BA, Shintani A, et al. Prevalence and risk factors for development of delirium in surgical and trauma intensive care unit patients. J Trauma 2008; 65:34–41.
Boncyk CS, Farrin E, Stollings JL, et al. Pharmacologic management of intensive care unit delirium: clinical prescribing practices and outcomes in more than 8500 patient encounters. Anesth Analg 2021; 133:713–722.
Esmaeeli S, Franco-Garcia E, Akeju O, et al. Association of preoperative frailty with postoperative delirium in elderly orthopedic trauma patients. Aging Clin Exp Res 2022; 34:625–631.
Chen TJ, Chung YW, Chang HC (Rita), et al. Diagnostic accuracy of the CAM-ICU and ICDSC in detecting intensive care unit delirium: A bivariate meta-analysis. Int J Nurs Stud 2021; 113:103782.
Boogaard Mvd, Pickkers P, Slooter AJC, et al. Development and validation of PRE-DELIRIC (PREdiction of DELIRium in ICu patients) delirium prediction model for intensive care patients: observational multicentre study. BMJ 2012; 344:e420.
Matsuoka A, Miike T, Miyazaki M, et al. Development of a delirium predictive model for adult trauma patients in an emergency and critical care center: a retrospective study. Trauma Surg Acute Care Open 2021; 6:e000827.
Steimer M, Kaiser S, Ulbrich F, et al. Expression of HO1 and PER2 can predict the incidence of delirium in trauma patients with concomitant brain injury. Sci Rep 2021; 11:15388.
Sullinger D, Gilmer A, Jurado L, et al. Development, implementation, and outcomes of a delirium protocol in the surgical trauma intensive care unit. Ann Pharmacother 2017; 51:5–12.
SCCM: ICU liberation bundle (A-F) [Internet]. Society of Critical Care Medicine (SCCM). [cited 15 November 2022]. Available at: https://www.sccm.org/Clinical-Resources/ICULiberation-Home/ABCDEF-Bundles . [Accessed 26 December 2022]
Park C, Bharija A, Mesias M, et al. Association between implementation of a geriatric trauma clinical pathway and changes in rates of delirium in older adults with traumatic injury. JAMA Surg 2022; 157:676–683.
Bannon L, McGaughey J, Verghis R, et al. The effectiveness of nonpharmacological interventions in reducing the incidence and duration of delirium in critically ill patients: a systematic review and meta-analysis. Intensive Care Med 2019; 45:1–12.
Herling SF, Greve IE, Vasilevskis EE, et al. Interventions for preventing intensive care unit delirium in adults. Cochrane Database Syst Rev 2018; 2019:
Golubovic J, Neerland BE, Aune D, et al. Music interventions and delirium in adults: a systematic literature review and meta-analysis. Brain Sci 2022; 12:568.
Kim T, Celis C, Pop A, et al. More medications, more problems: results from the Sedation Level after Emergent Exlap with Packing for TRAUMA (SLEEP-TRAUMA) study. Eur J Trauma Emerg Surg 2022; 48:943–952.
Kim MS, Rhim HC, Park A, et al. Comparative efficacy and acceptability of pharmacological interventions for the treatment and prevention of delirium: a systematic review and network meta-analysis. J Psychiatr Res 2020; 125:164–176.
Soltani F, Tabatabaei S, Jannatmakan F, et al. Comparison of the effects of haloperidol and dexmedetomidine on delirium and agitation in patients with a traumatic brain injury admitted to the intensive care unit. Anesthesiol Pain Med 2021; 11:e113802.
Lewis K, Alshamsi F, Carayannopoulos KL, et al. GUIDE group. Dexmedetomidine vs other sedatives in critically ill mechanically ventilated adults: a systematic review and meta-analysis of randomized trials. Intensive Care Med 2022; 48:811–840.
Pereira JV, Sanjanwala RM, Mohammed MK, et al. Dexmedetomidine versus propofol sedation in reducing delirium among older adults in the ICU: a systematic review and meta-analysis. Eur J Anaesthesiol 2020; 37:121–131.
Møller MH, Alhazzani W, Lewis K, et al. Use of dexmedetomidine for sedation in mechanically ventilated adult ICU patients: a rapid practice guideline. Intensive Care Med 2022; 48:801–810.
Khaing K, Nair BR. Melatonin for delirium prevention in hospitalized patients: a systematic review and meta-analysis. J Psychiatr Res 2021; 133:181–190.
Yan W, Li C, Song X, et al. Prophylactic melatonin for delirium in critically ill patients: a systematic review and meta-analysis with trial sequential analysis. Medicine (Baltimore) 2022; 101:e31411.
Abraham MP, Hinds M, Tayidi I, et al. Quetiapine for delirium prophylaxis in high-risk critically ill patients. The Surgeon 2021; 19:65–71.
Kim Y, Kim HS, Park JS, et al. Efficacy of low-dose prophylactic quetiapine on delirium prevention in critically ill patients: a prospective, randomized, double-blind, placebo-controlled study. J Clin Med 2019; 9:69.
Krause C, Kwon E, Luo-Owen X, et al. Dexmedetomidine and paralytic exposure after damage control laparotomy: risk factors for delirium? Results from the EAST SLEEP-TIME multicenter trial. Eur J Trauma Emerg Surg 2022; 48:2097–2105.
Thanapluetiwong S, Ruangritchankul S, Sriwannopas O, et al. Efficacy of quetiapine for delirium prevention in hospitalized older medical patients: a randomized double-blind controlled trial. BMC Geriatr 2021; 21:215.
Zipser CM, Spiller TR, Hildenbrand FF, et al. Discharge destinations of delirious patients: findings from a prospective cohort study of 27,026 patients from a large healthcare system. J Am Med Dir Assoc 2022; 23:1322.e2–1327.e2.