Intensive care unit delirium-a decade of learning.

Think of delirium as the phenotypic manifestation of global, acute brain dysfunction that can deprive patients of their dignity. This syndrome of acute changes in awareness, attention, and cognition is an independent predictor of death, length of stay, cost of care, and development of rapidly acquired dementia caused by numerous medical conditions rather than a specific underlying neurocognitive disorder. Delirium is largely invisible and missed 75% of the time by medical professionals, and is a public health problem with huge societal downstream impacts. There are a myriad of pathophysiological and neurotransmitter disturbances that combine to cause a patient's brain to go into delirium. These disturbances include a range of neuroinflammatory processes, cerebral vascular dysfunction, altered brain metabolism, neurotransmitter imbalance, impaired neuronal network connectivity, and even gut microbiota dysbiosis. 1 Wilson JE Mart MF Cunningham C et al. Delirium. Nat Rev Dis Primers. 2020; 6: 90 Crossref PubMed Scopus (265) Google Scholar