Delirium in the Cardiac Intensive Care Unit

D elirium is an important diagnosis, both because it is challenging to manage and because it portends a poor prognosis in the hospital and beyond. Delirium is particularly prevalent in the intensive care unit (ICU) setting, where it is associated with longer hospital stays, prolonged mechanical ventilation, increased hospital costs, and increases in mortality. In fact, studies have shown the incidence of delirium in mechanically ventilated patients to be as high as 85%. Furthermore, the negative ramifications of delirium extend beyond hospitalization, as afflicted patients are less likely to be discharged home and more likely to have longterm cognitive impairment. Consequently, prevention as well as prompt identification and treatment of delirium in the ICU is critical. While ICU delirium has been the subject of intense research and numerous review articles, little attention has been placed on the unique aspects of delirium related to patients in the cardiac ICU (CICU). In this article, we review recent understanding of the etiology, epidemiology, prevention, and treatment of delirium in the CICU, concluding with suggested future directions. Definition and Subtypes