Shadows in the Mind: Navigating Intensive Care Unit Delirium and Prevention

Delirium is a significant neuropsychiatric complication in intensive care unit (ICU) settings, characterized by acute disturbances in attention, awareness, and cognition. The incidence ranges from 30% to 80% among critically ill patients, with the highest rates observed in mechanically ventilated in...

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Main Authors: Shibu Sasidharan, Harpreet Dhillon
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2025-07-01
Series:APIK Journal of Internal Medicine
Subjects:
Online Access:https://journals.lww.com/10.4103/ajim.ajim_28_25
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author Shibu Sasidharan
Harpreet Dhillon
author_facet Shibu Sasidharan
Harpreet Dhillon
author_sort Shibu Sasidharan
collection DOAJ
description Delirium is a significant neuropsychiatric complication in intensive care unit (ICU) settings, characterized by acute disturbances in attention, awareness, and cognition. The incidence ranges from 30% to 80% among critically ill patients, with the highest rates observed in mechanically ventilated individuals. This syndrome is associated with substantial increases in mortality (hazard ratio [HR] 2.19, 95% confidence interval 1.78–2.70), extended ICU and hospital lengths of stay, and persistent cognitive impairment affecting up to 70% of survivors at 1-year follow-up. Recent evidence has established delirium as an independent predictor of long-term cognitive dysfunction, comparable to moderate traumatic brain injury or mild Alzheimer’s disease. This comprehensive review examines the current understanding of the pathophysiology, risk stratification approaches, evidence-based diagnostic methods, preventive interventions, and management strategies for ICU delirium. Addressing this syndrome through systematic multicomponent interventions represents an essential aspect of critical care medicine with significant implications for patient outcomes and healthcare resource utilization.
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spelling doaj-art-34863c3076ef4af7a19ff4ffb67cd3292025-08-20T03:31:41ZengWolters Kluwer Medknow PublicationsAPIK Journal of Internal Medicine2666-18022666-18102025-07-0113316116810.4103/ajim.ajim_28_25Shadows in the Mind: Navigating Intensive Care Unit Delirium and PreventionShibu SasidharanHarpreet DhillonDelirium is a significant neuropsychiatric complication in intensive care unit (ICU) settings, characterized by acute disturbances in attention, awareness, and cognition. The incidence ranges from 30% to 80% among critically ill patients, with the highest rates observed in mechanically ventilated individuals. This syndrome is associated with substantial increases in mortality (hazard ratio [HR] 2.19, 95% confidence interval 1.78–2.70), extended ICU and hospital lengths of stay, and persistent cognitive impairment affecting up to 70% of survivors at 1-year follow-up. Recent evidence has established delirium as an independent predictor of long-term cognitive dysfunction, comparable to moderate traumatic brain injury or mild Alzheimer’s disease. This comprehensive review examines the current understanding of the pathophysiology, risk stratification approaches, evidence-based diagnostic methods, preventive interventions, and management strategies for ICU delirium. Addressing this syndrome through systematic multicomponent interventions represents an essential aspect of critical care medicine with significant implications for patient outcomes and healthcare resource utilization.https://journals.lww.com/10.4103/ajim.ajim_28_25confusion assessment methoddeliriumintensive care unit
spellingShingle Shibu Sasidharan
Harpreet Dhillon
Shadows in the Mind: Navigating Intensive Care Unit Delirium and Prevention
APIK Journal of Internal Medicine
confusion assessment method
delirium
intensive care unit
title Shadows in the Mind: Navigating Intensive Care Unit Delirium and Prevention
title_full Shadows in the Mind: Navigating Intensive Care Unit Delirium and Prevention
title_fullStr Shadows in the Mind: Navigating Intensive Care Unit Delirium and Prevention
title_full_unstemmed Shadows in the Mind: Navigating Intensive Care Unit Delirium and Prevention
title_short Shadows in the Mind: Navigating Intensive Care Unit Delirium and Prevention
title_sort shadows in the mind navigating intensive care unit delirium and prevention
topic confusion assessment method
delirium
intensive care unit
url https://journals.lww.com/10.4103/ajim.ajim_28_25
work_keys_str_mv AT shibusasidharan shadowsinthemindnavigatingintensivecareunitdeliriumandprevention
AT harpreetdhillon shadowsinthemindnavigatingintensivecareunitdeliriumandprevention