COVID and Delirium

“A Waking Nightmare for COVID-19 Patients” In a new documentary coronavirus survivors describe frightening experiences in the intensive care unit. Respiratory failure known as ARDS (acute respiratory distress syndrome) that effects the most critically ill COVID-19 patients requires mechanical ventilation and up to 80% of patients on a ventilator will develop ICU delirium. One in 4 ARDS survivors will also develop PTSD. Many COVID patients describe nightmares, depression, and anxiety after their hospitalizations. Delirium is a strong predictor of adverse cognitive, physical, and psychological outcomes for ICU survivors. These problems called PICS (post-intensive care syndrome) that ICU patients can experience post-discharge affects up to 33% of patients on ventilators and 50% of patients who stay in the ICU for at least one week. Dr. Wes Ely, a professor of Pulmonary and Critical Care Medicine at Vanderbilt University School of Medicine states that “If you had to design an experiment to make delirium as bad as it could be, COVID is it. COVID is essentially a delirium factory”.

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Post ICU Delirium

“Why a stay in the ICU can leave patients worse off” Almost 6 million patients are admitted to an intensive care unit every year and for many it will mark a turning point in their lives. While one-third will return to normal, two-thirds will not return to their baseline or will decline even further. This is a substantial number of patients who are leaving the ICU facing many negative outcomes including anxiety, dementia, depression, and muscle and nerve problems. Some ICUs have developed new standards to decrease prolonged ventilation and increase mobility as a way to improve outcomes for these patients. As Dr. Wes Ely, a professor of Pulmonary and Critical Care Medicine at Vanderbilt University School of Medicine explains “We’re trying to get back to the humanness of critical care”.

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Message from the Past President, John Devlin, PharmD

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Understanding Delirium

Delirium is a rapid change in mental status. When delirium occurs it can be a frightening experience for caregivers and families. This video was developed to guide families through the initial phases of delirium treatment. This video was developed by Barbara Kamholz, MD during her tenure as a federal employee. She has given me permission to present it here, reproduction requires that appropriate credit be given.

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ICU delirium narration

Originally Published on Sep 26, 2013 A patient who spent days in a state of ICU delirium describes how real and how disabling the memories of his repeated accompanying nightmares have been. He speaks movingly of having experienced the horror of watching his daughter die on 4 separate occasions.

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