Synonym: intensive therapy unit (ITU) syndrome, ICU psychosis, critical care unit (CCU) syndrome
Features of the ICU Syndrome:
(1) rapid onset of clinical delirium with disturbances in consciousness and/or cognition
(2) often transient (1-2 days) but occasionally lasting up to 3 weeks
Risk factors:
(1) medications
(2) sleep deprivation
(3) electrolyte, glucose and metabolic disturbances
(4) multi-organ failure
(5) cytokine release
(6) perioperative factors including anesthesia
(7) drug and/or alcohol withdrawal
(8) seizures
(9) head trauma
(10) intracranial mass lesions or stroke
(11) personality traits and coping skills
(12) lack of contacts in the environment that assist in orientation
(13) pre-existing delirium or subclinical delirium
(14) pain
(15) anxiety and depression
Management:
(1) treating risk factors in the list above
(2) reducing contributory medications
(3) judicious use of anxiolytic and/pr antipsychotic drugs
(4) attempts to improve connections with the environmental and contact with others, especially family and friends
