Confusion or the post-intensive care syndrome

In the most seriously ill patients who receive care in the ICU, there is a substantial risk of delirium. Delirium is characterized by confusion, difficulty in paying attention, reduced awareness of person, place and time, and even the inability to interact with others.

Delirium is not a specific complication of COVID-19 but unfortunately is a common complication of ICU care. Risk factors in addition to being in the ICU include advanced age and pre-existing illness. Some studies say as many as 75% of patients treated in the ICU experience delirium. The problem is not only with confusion during the hospitalization, but for months after. For example, at three and nine months after discharge many of those who recovered still had difficulty with short-term memory, the ability to comprehend written and spoken words and to learn new things. Some even had difficulty knowing where they were and what today’s date was. And, executive function scores were significantly worse in those who had suffered from delirium.

Physicians are dedicating considerable effort to reduce delirium in patients in the ICU. Approaches that may help include reducing the use of sedatives, repeated reorientation of the patient to date, time and location, early mobilization, noise reduction and cognitive stimulation.

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