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G-I-N Conference 2012

Guidelines International Network

22.08 - 25.08.2012, Berlin

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Implementation of delirium monitoring according to the German S3-Guidelines for the management of analgesia, sedation and delirium in intensive care

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  • A. Luetz - Department of Anesthesiology and Intensive Care Medicine, Charité, Berlin, Germany
  • F. Balzer - Department of Anesthesiology and Intensive Care Medicine, Charité, Berlin, Germany
  • F. Radtke - Department of Anesthesiology and Intensive Care Medicine, Charité, Berlin, Germany
  • S. Fueger - Department of Anesthesiology and Intensive Care Medicine, Charité, Berlin, Germany
  • C. Jones - Whiston Hospital, Critical Care Unit, Liverpool, United Kingdom
  • G. Citerio - Hospital San Gerardo, Department of Emergency Medicine, Monza, Italy
  • B. Walder - Hôpitaux Universitaires de Genève, PACU and out-of-operating theatre anaesthesia, Geneva, Switzerland
  • C. Spies - Department of Anesthesiology and Intensive Care Medicine, Charité, Berlin, Germany

Guidelines International Network. G-I-N Conference 2012. Berlin, 22.-25.08.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocP157

doi: 10.3205/12gin269, urn:nbn:de:0183-12gin2696

Published: July 10, 2012

© 2012 Luetz et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

Text

Background: Delirium is seen in 11 to 87% of the ICU patients. It is associated with a threefold risk of dying within 6 months after ICU discharge and a worse cognitive outcome.

Objectives: The primary aim of the study was to investigate the implementation rate of delirium monitoring in ICU patients according to the German S3-Guideline (register number 001-012).

Methods: The study was designed as an anonymous international multicenter clinical survey. The data assessment was performed with 2 different online questionnaires. Repeated email invitations were sent to all members of the European Society of Intensive Care Medicine (ESICM). All ICUs were eligible for taking part in the study. Descriptive statistics were computed for all study variables using Aabel v3.0.6, Gigawiz Ltd. Co.

Results: A majority of the ICUs, 55% (56 of 101), reported some kind of screening for symptoms of delirium. Of those that did screen for delirium, 78% (44 of 56) used a validated assessment tool: CAM-ICU (n=37, 84%) > ICDSC > Nu-DESC / DDS. Antipsychotics (n=86, 85%) and benzodiazepines (n=81, 80%) were the two categories of medications most commonly chosen by the healthcare professionals to manage delirum.

Discussion: The data reflect an increasing awareness for delirium monitoring amongst intensivits. This may partially explain the increased implentation rates of specific delirium assessment tools measured in this survey.

Implications for guideline developers/users: This survey indicates, that knowledge regarding delirium management has improved. National and international guidelines are important instruments to integrate current best evidence from research with clinical policy and practice.