Emotional consequences of intensive care unit delirium and delusional memories after intensive care unit admission: A systematic review

Abstract

Based on current literature, no relationship could be shown for delirium and emotional outcome. Regarding delusional memories and adverse emotional outcome, results were in contradiction.

“Releasing a lot of poisons from my mind”: Patients' delusional memories of intensive care

“…17 The presence of delusional memories may suggest ICU delirium however, a systematic review found no relationship between delirium and PTSD. 18 …”

Sedation and Its Association With Posttraumatic Stress Disorder After Intensive Care

“…Additionally, benzodiazepines can have a prolonged half-life in critically ill patients. 23 Although the findings from a recent meta-analysis 24 raise questions about the relationship between these medications and delirium, the Society of Critical Care Medicine 2013 guidelines, 25 based on available evidence, state that "sedation strategies using nonbenzodiazepine sedatives may be preferred over sedation with benzodiazepines. "…”

“…A recent meta-analysis 24 of 34 studies indicated that although delirium alone is not correlated with PTSD, whether or not memories of delirious episodes are contributory is unclear. As Weinert and Sprenkle 20 suggest, the character of the ICU experience may have a greater influence on psychological outcomes than the level of sedation does.…”

Recovery After ICU Discharge: Post–Intensive Care Syndrome

“…9 The lowest dose of sedation agent should be administered to achieve patient comfort, and when possible, benzodiazepine agents should be limited or avoided. [1][2][3][4][5]9 Frequently assessing the patient's readiness to wean from mechanical ventilation is another intervention that may be used to reduce the risk of PICS. Performing daily spontaneous awakening trials coupled with spontaneous breathing trials is important to allow a reduction in sedation agents, perform a neurologic assessment, and evaluate the patient's readiness to extubate.…”

“…Cognitive and psychological stressors frequently occur arising from sleep deprivation, sedation, anxiety, fear, delusional memories, and delirium. 3 A rising body of evidence reports cognitive and psychological consequences for ICU survivors that alter the patient's reported quality of life. Recent studies estimate 25% to 75% of ICU survivors report challenges with depressive symptoms, anxiety, cognitive impairment, and/or posttraumatic stress disorder.…”