ICU Delirium also known as ICU Psychosis is the umbrella term for psychiatric symptoms that occur after residing in an ICU unit. It is believed that various aspects of the ICU such as the constant beeping of monitors, monotony, and multiple stressors lead to “a fluctuating level of consciousness, poor orientation, delusions and hallucinations, and behavioral anomalies, such as aggression or passivity”. ICU psychosis typically lasts 23-24 hours however there have been cases lasting up to 14.7 days. With ⅔ of people in the ICU experiencing this disease, it is vital that people understand how and why it occurs.
The Causes of ICU Delirium
Physiological disturbances are caused by an organ malfunctioning in the body. Apart from this, ICU Delirium is also caused by
Metabolic disturbances- Abnormal Chemical Reactions disrupting Homeostasis in the body
Electrolyte imbalances- An abnormal concentration of electrolytes, minerals that give off an electrical charge when they dissolve fluids such as blood. Symptoms may include confusion, nausea, irritability, headaches, and muscle spasms.
Withdrawal syndromes- Various physical symptoms such as insomnia, irritability, changing moods, depression, and anxiety, may occur after one decides to stop using drugs or alcohol.
Acute infection (intracranial and systemic)-A disease that occurs rapidly
Seizures- A sudden uncontrolled disturbance in the brain
Vascular disorders- Any disease that affects veins and arteries
Intracranial space-occupying lesions- Tumors that form in the Intracranial cavity inhibiting normal brain function
The ICU environment- THe ICU environment includes social isolation, immobilization, unfamiliar surroundings, excessive noise, and sensory monotony, and they all increase the risk of ICU delirium
Managing ICU Delirium
When one goes about treating ICU delirium it is imperative to treat both the symptoms and the causes of delirium. This can be done by undergoing numerous tests such as measuring arterial blood gas levels, a chest x-ray, and a biochemical screen. Tests such as these may help determine the causes of ICU delirium. Once the cause of delirium is identified it is important to attempt to reverse it as much as possible in order to prevent further damage. Then one can begin treating the symptoms such as headaches and hallucinations. It is important not to prescribe Benzodiazepines as they may amplify hallucinations. It is imperative that medical professionals understand and quickly recognize the signs of ICU delirium.
Works Cited
Dr. Colin Tidy. “Space-Occupying Lesions of the Brain.” Patient.info, 2 Dec. 2016, patient.info/doctor/space-occupying-lesions-of-the-brain.
“Electrolyte Imbalance: Types, Symptoms, Causes & Treatment.” Cleveland Clinic, my.clevelandclinic.org/health/symptoms/24019-electrolyte-imbalance#:~:text=What%20is%20an%20electrolyte%20imbalance.
Health Direct. “Addiction Withdrawal Symptoms.” Healthdirect.gov.au, Healthdirect Australia, 4 Apr. 2018, www.healthdirect.gov.au/addiction-withdrawal-symptoms.
McGuire, Brian E., et al. “Intensive Care Unit Syndrome.” Archives of Internal Medicine, vol. 160, no. 7, 10 Apr. 2000, p. 906, jamanetwork.com/journals/jamainternalmedicine/fullarticle/522898, 10.1001/archinte.160.7.906. Accessed 22 May 2021.
“Metabolic Disorders.” Medlineplus.gov, medlineplus.gov/metabolicdisorders.html#:~:text=A%20metabolic%20disorder%20occurs%20when.
“Seizures - Symptoms and Causes.” Mayo Clinic, www.mayoclinic.org/diseases-conditions/seizure/symptoms-causes/syc-20365711#:~:text=Overview.
“What Is ICU Delirium?” Myhealth.alberta.ca, myhealth.alberta.ca/Alberta/Pages/what-is-icu-delirium.aspx.
What Is Vascular Disease? - Vascular Cures. 2 Sept. 2021, vascularcures.org/patients/what-is-vascular-disease/#:~:text=Our%20Contact%20page-. Accessed 22 Nov. 2022.
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