Education  |   December 2016
Intensive Care Unit Delirium: A Review of Diagnosis, Prevention, and Treatment
Author Notes
  • From the Division of Anesthesiology Critical Care Medicine, Department of Anesthesiology, Vanderbilt University School of Medicine, Nashville, Tennessee.
  • This article has been selected for the Anesthesiology CME Program. Learning objectives and disclosure and ordering information can be found in the CME section at the front of this issue.
    This article has been selected for the Anesthesiology CME Program. Learning objectives and disclosure and ordering information can be found in the CME section at the front of this issue.×
  • Submitted for publication April 27, 2016. Accepted for publication August 24, 2016.
    Submitted for publication April 27, 2016. Accepted for publication August 24, 2016.×
  • This article is featured in “This Month in Anesthesiology,” page 1A.
    This article is featured in “This Month in Anesthesiology,” page 1A.×
  • Figures 1 and 2 were enhanced by Annemarie B. Johnson, C.M.I., Medical Illustrator, Vivo Visuals, Winston-Salem, North Carolina.
    Figures 1 and 2 were enhanced by Annemarie B. Johnson, C.M.I., Medical Illustrator, Vivo Visuals, Winston-Salem, North Carolina.×
  • Address correspondence to Dr. Hughes: Division of Anesthesiology Critical Care Medicine, Department of Anesthesiology, Vanderbilt University School of Medicine, 1211 21st Avenue South, Medical Arts Building 526, Nashville, Tennessee 37212. christopher.hughes@vanderbilt.edu. Information on purchasing reprints may be found at www.anesthesiology.org or on the masthead page at the beginning of this issue. Anesthesiology’s articles are made freely accessible to all readers, for personal use only, 6 months from the cover date of the issue.
Article Information
Education / Clinical Concepts and Commentary / Central and Peripheral Nervous Systems / Critical Care
Education   |   December 2016
Intensive Care Unit Delirium: A Review of Diagnosis, Prevention, and Treatment
Anesthesiology 12 2016, Vol.125, 1229-1241. doi:10.1097/ALN.0000000000001378
Anesthesiology 12 2016, Vol.125, 1229-1241. doi:10.1097/ALN.0000000000001378
A 77-YR-OLD man is admitted to the hospital after sustaining a hip fracture. He has a medical history of chronic obstructive pulmonary disease, hypertension, hyperlipidemia, chronic back pain, and hearing loss. Before surgery, he receives midazolam for agitation and morphine for pain control. He undergoes a general anesthetic for his fracture repair, requiring high doses of fentanyl for pain control. Postoperatively, he has poor pulmonary mechanics and is taken to the intensive care unit (ICU) intubated and mechanically ventilated. On postoperative day 1, his sedation is weaned and he is put on a spontaneous breathing trial. While he appears intermittently awake, he will not follow commands and only intermittently makes eye contact. The patient is left intubated due to his altered mental status.
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