Clinical Review: Agitation and Delirium in the Critically Ill – Significance and Management

Jean-Claude Chevrolet and Philippe Jolliet

Critical Care 2007, 11:214

Agitation is by definition a psychomotor disturbance characterized by a marker increase in patient's motor and psychological activity. It occurs very frequently in the intensive care setting. It may be isolated or accompanied by other mental disorders, such as severe anxiety and delirium. Frequently, agitation is a sign of brain dysfunction and may have adverse consequences, for at least two reasons. First, agitation can interfere with the patient’s care and, second, there is evidence demonstrating that the prognosis of agitated (and delirious) patients is worse than that of non-agitated (non-delirious) patients. These conditions are often underdiagnosed in the intensive care unit (ICU). Consequently, a systematic evaluation of this problem in ICU patients should be conducted. Excellent tools are presently available for this purpose. Treatment, including prevention, must be undertaken without delay, and the ICU physician should follow logical, strict and systematic rules when applying therapy.

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