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Assessment and therapeutic strategy for agitation, confusion, and delirium in the ICU 

Assessment and therapeutic strategy for agitation, confusion, and delirium in the ICU
Chapter:
Assessment and therapeutic strategy for agitation, confusion, and delirium in the ICU
Author(s):

Michele C. Balas

and E. Wesley Ely

DOI:
10.1093/med/9780199600830.003.0227
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date: 30 November 2020

Agitation and delirium are conditions that are highly prevalent in the intensive care unit (ICU). Both are believed to be caused by a number of modifiable and non-modifiable risk factors, and present with a variety of signs and symptoms. Consequently, these conditions are notoriously difficult to detect and treat. Variations in sedative practices, misperceptions regarding delirium and its association with outcomes, and lack of knowledge regarding screening tools, may all impede effective assessment, and management of agitation and delirium. A further complication is that many of the medications used to treat critically-ill patients are now known to increase the risk of delirium. While studies conducted over the last decade have significantly contributed to our understanding of how best to diagnose, prevent, and manage these common conditions, this knowledge is not always successfully adopted into everyday clinical practice. This chapter provides readers with an evidence-based review of agitation and delirium assessment and therapeutic strategies applicable for use in the ICU setting.

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