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Intensive Care Med. 2017 Sep;43(9):1329-1339. doi: 10.1007/s00134-017-4860-7. Epub 2017 Jun 13.

The intensive care delirium research agenda: a multinational, interprofessional perspective.

Author information

1
Division of Anesthesiology Critical Care Medicine, Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN, USA. Pratik.pandharipande@vanderbilt.edu.
2
Division of Pulmonary and Critical Care and Health Services Research, Vanderbilt University and VA-GRECC, Nashville, TN, USA.
3
Department of Surgery, St. Boniface Hospital, University of Manitoba, Winnipeg, MB, Canada.
4
Center of Excellence in Critical and Complex Care, College of Nursing, The Ohio State University, Columbus, OH, USA.
5
Indiana University Center for Health Innovation and Implementation Science, Indianapolis, IN, USA.
6
International Research Project Humanizing Intensive Care (Proyecto HU-CI), Intensive Care Unit, Hospital Universitario de Torrejón, Madrid, Spain.
7
School of Biochemistry and Immunology, Trinity College Institute of Neuroscience, Lloyd Institute, Trinity College Dublin, Dublin, Ireland.
8
School of Pharmacy, Northeastern University, Boston, USA.
9
Division of Pulmonary, Critical Care and Sleep Medicine, Tufts Medical Center, Boston, MA, USA.
10
Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, Canada.
11
Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
12
Edinburgh Delirium Research Group, Geriatric Medicine Unit, University of Edinburgh, Edinburgh, Scotland, UK.
13
Stanford University School of Medicine, Stanford, CA, USA.
14
Department of Rehabilitation, Ancelle Hospital, Cremona, Italy.
15
Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, MD, USA.
16
Watford General Hospital, Watford, UK.
17
Sunnybrook Health Sciences Centre, Toronto, Canada.
18
Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada.
19
Department of Critical Care, rD' OR Institute for Research and Education and Post-Graduate Program Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
20
Department of Intensive Care Medicine, Raymond Poincaré Hospital, Paris, France.
21
Laboratory of Human Histology and Animal Models, Institut Pasteur, Paris, France.
22
School of Clinical Sciences, Faculty of Medicine, Monash University and Medical Center, Melbourne, Australia.
23
Clinical School of Medicine, University New South Wales, Sydney, NSW, 2031, Australia.
24
Department of Medicine, McGill University, Montreal, Canada.
25
Department of Intensive Care Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
26
Division of Pediatric Cardiac Anesthesia, Department of Anesthesiology and Pediatrics, Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, TN, USA.

Abstract

Delirium, a prevalent organ dysfunction in critically ill patients, is independently associated with increased morbidity. This last decade has witnessed an exponential growth in delirium research in hospitalized patients, including those critically ill, and this research has highlighted that delirium needs to be better understood mechanistically to help foster research that will ultimately lead to its prevention and treatment. In this invited, evidence-based paper, a multinational and interprofessional group of clinicians and researchers from within the fields of critical care medicine, psychiatry, pediatrics, anesthesiology, geriatrics, surgery, neurology, nursing, pharmacy, and the neurosciences sought to address five questions: (1) What is the current standard of care in managing ICU delirium? (2) What have been the major recent advances in delirium research and care? (3) What are the common delirium beliefs that have been challenged by recent trials? (4) What are the remaining areas of uncertainty in delirium research? (5) What are some of the top study areas/trials to be done in the next 10 years? Herein, we briefly review the epidemiology of delirium, the current best practices for management of critically ill patients at risk for delirium or experiencing delirium, identify recent advances in our understanding of delirium as well as gaps in knowledge, and discuss research opportunities and barriers to implementation, with the goal of promoting an integrated research agenda.

KEYWORDS:

Cognitive impairment; Delirium; Research agenda

PMID:
28612089
PMCID:
PMC5709210
DOI:
10.1007/s00134-017-4860-7
[Indexed for MEDLINE]
Free PMC Article

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