BACKGROUND: Delirium is an acute organ dysfunction common amongst patients treated in intensive care units. The associated morbidity and mortality are known to be substantial. Previous surveys have described which screening tools are used to diagnose delirium and which medications are used to treat delirium, but these data are not available for the United Kingdom. AIM: This survey aimed to describe the UK management of delirium by consultant intensivists. Additionally, knowledge and attitudes towards management of delirium were sought. The results will inform future research in this area. METHODS: A national postal survey of members of the UK Intensive Care Society was performed. A concise two page questionnaire survey was sent, with a second round of surveys sent to non-respondents after 6 weeks. The questionnaire was in tick-box format. RESULTS: Six hundred and eighty-one replies were received from 1308 questionnaires sent, giving a response rate of 52%. Twenty-five percent of respondents routinely screen for delirium, but of these only 55% use a screening tool validated for use in intensive care. The majority (80%) of those using a validated instrument used the Confusion Assessment Method for the Intensive Care Unit. Hyperactive delirium is treated pharmacologically by 95%; hypoactive delirium is treated pharmacologically by 25%, with haloperidol the most common agent used in both. Over 80% of respondents agreed that delirium prolongs mechanical ventilation and hospital stay and requires active treatment. CONCLUSION: This UK survey demonstrates screening for delirium is sporadic. Pharmacological treatment is usually with haloperidol in spite of the limited evidence to support this practice. Hypoactive delirium is infrequently treated pharmacologically.
BACKGROUND:Delirium is an acute organ dysfunction common amongst patients treated in intensive care units. The associated morbidity and mortality are known to be substantial. Previous surveys have described which screening tools are used to diagnose delirium and which medications are used to treat delirium, but these data are not available for the United Kingdom. AIM: This survey aimed to describe the UK management of delirium by consultant intensivists. Additionally, knowledge and attitudes towards management of delirium were sought. The results will inform future research in this area. METHODS: A national postal survey of members of the UK Intensive Care Society was performed. A concise two page questionnaire survey was sent, with a second round of surveys sent to non-respondents after 6 weeks. The questionnaire was in tick-box format. RESULTS: Six hundred and eighty-one replies were received from 1308 questionnaires sent, giving a response rate of 52%. Twenty-five percent of respondents routinely screen for delirium, but of these only 55% use a screening tool validated for use in intensive care. The majority (80%) of those using a validated instrument used the Confusion Assessment Method for the Intensive Care Unit. Hyperactive delirium is treated pharmacologically by 95%; hypoactive delirium is treated pharmacologically by 25%, with haloperidol the most common agent used in both. Over 80% of respondents agreed that delirium prolongs mechanical ventilation and hospital stay and requires active treatment. CONCLUSION: This UK survey demonstrates screening for delirium is sporadic. Pharmacological treatment is usually with haloperidol in spite of the limited evidence to support this practice. Hypoactive delirium is infrequently treated pharmacologically.
Authors: Alessandro Morandi; Eduard Vasilevskis; Pratik P Pandharipande; Timothy D Girard; Laurence M Solberg; Erin B Neal; Tyler Koestner; Renee E Torres; Jennifer L Thompson; Ayumi K Shintani; Jin H Han; John F Schnelle; Donna M Fick; E Wesley Ely; Sunil Kripalani Journal: J Am Geriatr Soc Date: 2013-07 Impact factor: 5.562
Authors: Valerie J Page; E Wesley Ely; Simon Gates; Xiao Bei Zhao; Timothy Alce; Ayumi Shintani; Jim Jackson; Gavin D Perkins; Daniel F McAuley Journal: Lancet Respir Med Date: 2013-08-21 Impact factor: 30.700
Authors: Timothy D Girard; Matthew C Exline; Shannon S Carson; Catherine L Hough; Peter Rock; Michelle N Gong; Ivor S Douglas; Atul Malhotra; Robert L Owens; Daniel J Feinstein; Babar Khan; Margaret A Pisani; Robert C Hyzy; Gregory A Schmidt; William D Schweickert; R Duncan Hite; David L Bowton; Andrew L Masica; Jennifer L Thompson; Rameela Chandrasekhar; Brenda T Pun; Cayce Strength; Leanne M Boehm; James C Jackson; Pratik P Pandharipande; Nathan E Brummel; Christopher G Hughes; Mayur B Patel; Joanna L Stollings; Gordon R Bernard; Robert S Dittus; E Wesley Ely Journal: N Engl J Med Date: 2018-10-22 Impact factor: 91.245
Authors: Leona Bannon; Jennifer McGaughey; Rejina Verghis; Mike Clarke; Daniel F McAuley; Bronagh Blackwood Journal: Intensive Care Med Date: 2018-11-30 Impact factor: 17.440