Deliriumduring Weaning from Mechanical Ventilation

Abstract

Background. We compare the incidence ofdeliriumbefore and after extubation and identify the risk factors and possible predictors for the occurrence ofdeliriumin this group of patients.Methods. Patients weaned from mechanical ventilation (MV) and extubated were included. The assessment ofdeliriumwas conducted using the confusion assessment method for the ICU and completed twice per day until discharge from the intensive care unit.Results. Sixty-four patients were included in the study, 53.1% of whom presented withdelirium. The risk factors ofdeliriumwere age (P=0.01), SOFA score (P=0.03), APACHE score (P=0.01), and a neurological cause of admission (P=0.01). The majority of the patients began withdeliriumbefore or on the day of extubation. Hypoactivedeliriumwas the most common form.Conclusion. Acute (traumatic or medical) neurological injuries were important risk factors in the development ofdelirium. During the weaning process,deliriumdeveloped predominantly before or on the same day of extubation and was generally hypoactive (more difficult to detect). Therefore, while planning early prevention strategies, attention must be focused on neurological patients who are receiving MV and possibly even on patients who are still under sedation.