Encuesta iberoamericana sobre delirium en pacientes críticos / Latin American survey on delirium in critical patients

Objetivos El objetivo del presente estudio es establecer los conceptos y prácticas de los intensivistas en el diagnóstico, manejo y prevención del delirium en Unidades de Cuidado Intensivo (UCI). Diseño Se distribuyó una encuesta entre las sociedades miembro de la FEPIMCTI, para que la distribuyeran entre sus socios médicos. Resultados Un total de 854 intensivistas de 12 países respondieron la encuesta. La mayor parte de Argentina, México, Chile y Colombia. Hubo mayoría de UCI académicas (70,5%). El 56,55% respondió que evaluaba el diagnóstico de delirium siempre y solo el 10,2% respondió que nunca. El 69,5% hacia una evaluación clínica general y solo el 19,6% empleaba la escala CAM-ICU y el 9% usaba la lista de chequeo de evaluación de delirio. El 88,3% estuvo de acuerdo o totalmente de acuerdo en que el delirium era un evento esperado en UCI. El 90,1% estuvo de acuerdo que el delirium es subdiagnosticado en UCI. El 97% respondió que es un problema prevenible que requiere intervención. El 74,5% opinó que se seda en forma excesiva en UCI y 70,5% consideró que los opioides se asocian con la aparición del delirium, mientras que el 87,1% que algunos sedantes favorecen su desarrollo. Resultados El 70,2% consideró que es un factor de riesgo para NAV y que dificulta la extubación el 87,8% de los consultados. Conclusiones A pesar de considerar al delirium como un problema frecuente, prevenible y con graves repercusiones para el paciente crítico, los intensivistas encuestados no emplean una herramienta para su evaluación en UCI. Son necesarios esfuerzos educacionales para difundir la eficacia y la utilidad de las escalas que permiten el diagnóstico precoz y preciso del delirium en UCI (AU)

Objectives This study has aimed to establish the intensivist physician's concepts and practices in this region regarding the diagnosis, management and prevention of delirium in intensive care units (ICU). Design A survey was distributed among the FEPIMCTI member societies for distribution among its medical members. Results Eight hundred fifty-four intensive care physicians from 12 Latin America countries, most of them from Argentina, Mexico, Chile and Colombia, responded to the survey. There was a majority of academic ICUs (70.5%). A total of 56.55% responded that they always evaluated the diagnosis of delirium and only 10.2% answered never. A general clinical assessment was made by 69.5%, only 19.6% used the CAM-ICU scale and 9% the checklist assessment of delirium. It was agreed or strongly agreed by 88.3% that delirium was an expected event in the ICU and by 90.1% that delirium was underdiagnosed in ICU. A total of 97% responded that it was a problem that requires intervention and which is preventable (66.5%). It was considered that excessive sedation is given in the ICU by 74.5% and 70.5% believed that opiates are associated with the onset of delirium, while 87.1% considered that some sedatives are associated with its development. Results Ventilator-associated pneumonia (VAP) was considered as a risk factor by 70.2% of the respondents and 87.8% considered that it made extubation difficult. Conclusions Although delirium is considered to be a common and preventable problem with serious implications for critically ill patients, the intensivist physicians surveyed do not use a tool for its evaluation in the ICU. Educational efforts are needed to disseminate the effectiveness and usefulness of the scales that allow for early and accurate diagnosis of delirium in the ICU (AU)

[Latin American survey on delirium in critical patients]. / Encuesta iberoamericana sobre delirium en pacientes críticos.

OBJECTIVES: This study has aimed to establish the intensivist physician's concepts and practices in this region regarding the diagnosis, management and prevention of delirium in intensive care units (ICU). DESIGN: A survey was distributed among the FEPIMCTI member societies for distribution among its medical members. RESULTS: Eight hundred fifty-four intensive care physicians from 12 Latin America countries, most of them from Argentina, Mexico, Chile and Colombia, responded to the survey. There was a majority of academic ICUs (70.5%). A total of 56.55% responded that they always evaluated the diagnosis of delirium and only 10.2% answered never. A general clinical assessment was made by 69.5%, only 19.6% used the CAM-ICU scale and 9% the checklist assessment of delirium. It was agreed or strongly agreed by 88.3% that delirium was an expected event in the ICU and by 90.1% that delirium was underdiagnosed in ICU. A total of 97% responded that it was a problem that requires intervention and which is preventable (66.5%). It was considered that excessive sedation is given in the ICU by 74.5% and 70.5% believed that opiates are associated with the onset of delirium, while 87.1% considered that some sedatives are associated with its development. Ventilator-associated pneumonia (VAP) was considered as a risk factor by 70.2% of the respondents and 87.8% considered that it made extubation difficult. CONCLUSIONS: Although delirium is considered to be a common and preventable problem with serious implications for critically ill patients, the intensivist physicians surveyed do not use a tool for its evaluation in the ICU. Educational efforts are needed to disseminate the effectiveness and usefulness of the scales that allow for early and accurate diagnosis of delirium in the ICU.