Delirium-related psychiatric and neurocognitive impairment and the association with post-intensive care syndrome-A narrative review
Ramnarain, Dharmanand (Elisabeth-Tweesteden Hospital (Tilburg))
Pouwels, Sjaak (Elisabeth-Tweesteden Hospital (Tilburg))
Fernández-Gonzalo, Sol (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Navarra-Ventura, Guillem (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Balanzá-Martínez, Vicent (Universitat de València)
Universitat Autònoma de Barcelona. Departament de Psicologia Clínica i de la Salut

Fecha:	2023
Resumen:	Introduction: Delirium is common among patients admitted to the intensive care unit (ICU) and its impact on the neurocognitive and psychiatric state of survivors is of great interest. These new-onset or worsening conditions, together with physical alterations, are called post-intensive care syndrome (PICS). Our aim is to update on the latest screening and follow-up options for psychological and cognitive sequelae of PICS. Method: This narrative review discusses the occurrence of delirium in ICU settings and the relatively new concept of PICS. Psychiatric and neurocognitive morbidities that may occur in survivors of critical illness following delirium are addressed. Future perspectives for practice and research are discussed. Results: There is no "gold standard" for diagnosing delirium in the ICU, but two extensively validated tools, the confusion assessment method for the ICU and the intensive care delirium screening checklist, are often used. PICS complaints are frequent in ICU survivors who have suffered delirium and have been recognized as an important public health and socio-economic problem worldwide. Depression, anxiety, post-traumatic stress disorder, and long-term cognitive impairment are recurrently exhibited. Screening tools for these deficits are discussed, as well as the suggestion of early assessment after discharge and at 3 and 12 months. Conclusions: Delirium is a complex but common phenomenon in the ICU and a risk factor for PICS. Its diagnosis is challenging with potential long-term adverse outcomes, including psychiatric and cognitive difficulties. The implementation of screening and follow-up protocols for PICS sequelae is warranted to ensure early detection and appropriate management.
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article de revisió ; recerca ; Versió publicada
Materia:	Delirium ; Emotional symptoms ; ICU ; Neurocognitive impairment ; Post-intensive care syndrome
Publicado en:	Acta psychiatrica Scandinavica, Vol. 147 Núm. 5 (may 2023) , p. 460-474, ISSN 1600-0447

DOI: 10.1111/acps.13534

15 p, 1.7 MB

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