FACTORS ASSOCIATED WITH DELIRIUM IN CRITICALLY ILL PATIENTS ADMITTED TO AN INTENSIVE CARE UNIT

Abstract

Delirium is an acute neuropsychiatric syndrome characterized by changes in attention, consciousness and cognition, with a high frequency among critically ill patients admitted to Intensive Care Units (ICU). Its occurrence is associated with increased morbidity and mortality, prolonged hospital stay, greater need for mechanical ventilation and possible cognitive impairment after discharge. This study aimed to analyze the main factors associated with the development of delirium in critically ill patients admitted to the ICU, highlighting clinical, therapeutic and environmental conditions that may contribute to its appearance. Related factors include advanced age, severity of the disease, presence of infections, metabolic changes, organic failure, fluid and electrolyte disorders, sleep deprivation and immobility. Furthermore, the use of certain medications, especially sedatives and analgesics, may be associated with the development of the syndrome, particularly when used in high doses or for prolonged periods. Mechanical ventilation, prolonged stay in the ICU and continuous exposure to environmental stimuli, such as noise, excessive light and frequent sleep interruptions, are also identified as conditions related to delirium. The early identification of risk factors is essential for implementing preventive strategies and for the appropriate management of patients. In this context, systematic assessment of the neurological status, reduction of sedation when clinically possible, promotion of sleep, early mobilization, maintenance of temporal and spatial orientation and the participation of family members in care are recommended. The approach must be multidisciplinary, involving doctors, nurses, physiotherapists and other health team professionals. It is concluded that delirium in critically ill patients has a multifactorial origin, resulting from the interaction between individual characteristics, clinical conditions, therapeutic interventions and environmental factors. In this way, the recognition of associated factors allows directing preventive and therapeutic measures, contributing to patient safety, reducing complications and improving clinical outcomes during and after ICU admission.