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In the ICU – delirium post cardiac arrest

Boncyk, Christina S.; Rengel, Kimberly F.; Pandharipande, Pratik P.; Hughes, Christopher G.

Current Opinion in Critical Care: June 2019 - Volume 25 - Issue 3 - p 218–225
doi: 10.1097/MCC.0000000000000615

Purpose of review The present review aims to describe the clinical impact and assessment tools capable of identifying delirium in cardiac arrest survivors and providing strategies aimed at preventing and treating delirium.

Recent findings Patient factors leading to a cardiac arrest, initial resuscitation efforts, and postresuscitation management all influence the potential for recovery and the risk for development of delirium. Data suggest that delirium in cardiac arrest survivors is an independent risk factor for morbidity and mortality. Recognizing delirium in postcardiac arrest patients can be challenging; however, detection is not only achievable, but important as it may aid in predicting adverse outcomes. Serial neurologic examinations and delirium assessments, targeting light sedation when possible, limiting psychoactive medications, and initiating patient care bundles are important care aspects for not only allowing early identification of primary and secondary brain injury, but in improving patient morbidity and mortality.

Summary Developing delirium after cardiac arrest is associated with increased morbidity and mortality. The importance of addressing modifiable risk factors, recognizing symptoms early, and initiating coordinated treatment strategies can help to improve outcomes within this high risk population.

Division of Critical Care Medicine, Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee, USA

Correspondence to Christina S. Boncyk, MD, 1211 21st Avenue South, Medical Arts Building #422, Nashville, TN 37212, USA. Tel: +1 615 936 2857; fax: +1 615 936 2857; e-mail:

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