tag:blogger.com,1999:blog-1474751880645498536.post7234621083421539914..comments2023-10-10T10:14:36.340-04:00Comments on Medical Evidence Blog: Does Investigating Delirium Make You Delirious? A Sober Look at Sedation and Analgesia in the ICUScott K. Aberegg, M.D., M.P.H.http://www.blogger.com/profile/17564774546019869201noreply@blogger.comBlogger3125tag:blogger.com,1999:blog-1474751880645498536.post-8463444433262936072014-09-26T18:59:45.408-04:002014-09-26T18:59:45.408-04:00Do you need the CAM-ICU to know that a patient is ...Do you need the CAM-ICU to know that a patient is delirious? The same argument could be made for daily labs or daily xrays. And I think we now know that those are not justified and may precipitate misadventures.Scott K. Aberegg, M.D., M.P.H.https://www.blogger.com/profile/17564774546019869201noreply@blogger.comtag:blogger.com,1999:blog-1474751880645498536.post-68621530286811983932014-09-26T12:35:59.694-04:002014-09-26T12:35:59.694-04:00You make the false assumption that all delirium as...You make the false assumption that all delirium assessments are related to "sedation". Delirium is often the canary in the coal mine for an impending event and can be a valuable warning sign. It is quite often simply a change in mentation that will herald an early sepsis, dvt, mi, etc. A task as simple as checking a CAM-ICU is not worthy of so much scorn.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-1474751880645498536.post-62735401566629563882014-04-19T10:28:47.940-04:002014-04-19T10:28:47.940-04:00I couldn't agree more with regards to delirium...I couldn't agree more with regards to delirium assessment and treatment!<br /><br />There is consistent evidence that ICU delirium is ASSOCIATED with poorer outcomes, but there is a lack of data showing CAUSATION or that delirium treatment modifies this risk. Association doesn't prove causation, and an onslaught of studies showing delirium being associated with poorer outcomes (after correcting for baseline imbalances with regression techniques) isn't convincing enough to warrant frequent CAM-ICU assessments.<br /><br />As you mention, even if a patient does have ICU delirium, there are no consistently proven therapies that reduce delirium AND improve patient outcomes. Delirium should absolutely be an area of research, but I don't view it as a "must have" for the daily ICU setting.Sean Kanehttp://clincalc.comnoreply@blogger.com