acute confusion state
Delirium vs dementia
- Delirium: awareness
- Dementia: memory
Types
- Hyperactive
- Hypoactive
- Mixed
C/F
- Inattention
- Disorganised thinking
- Coma
- MMSE or CAM-ICU
Pathophysiology
- Imbalance in the synthesis, release and inactivation of neurotransmitters
- Pathways involved
- Dopamine
- Glutamine
- Cholinergic
Triggers
- Extrinsic
- Physical restrains
- Urinary catheter
- Intrinsic
Electrophysiological
- Hypoxemia
- Hypercarbia
- electrolyte imbalance
Systemic causes
- Anaemia
- Malnutrition
- Metabolic disorders
- Surgeon cause
- Uncontrolled pain
- Non judicious use of opioids
- Sepsis
- Anaemia
Causes
- Drugs
- Opioids
- anticholinergics
- GA
Treatment
- ABCDE bundle by Morandi
- Awake and breathing
- Choice of sedation
- Delirium monitoring
- Early mobility and exercise
- Pharmacological measures: Halopiridol