Caracterização de pacientes com Delirium internados em Unidades de Terapia Intensiva Adulto / Characterization of patients with Delirium hospitalized in Adults Intensive Care Units (original) (raw)

2019, Arquivos Médicos dos Hospitais e da Faculdade de Ciências Médicas da Santa Casa de São Paulo

Introduction: Delirium is a disorder of consciousness and cognition, which has the characteristics of decreased attention and secondary changes such as perception, memory, orientation and reasoning. Risk factors include advanced age, sleep deprivation, immobility, dehydration, use of sedatives. ICU admission with numerous factors that interfere with the patient's condition due to patient complexity and care may further aggravate delirium. Objective: To characterize the profile of patients with Delirium hospitalized in Adult Intensive Care Units. Method: This is an exploratory, descriptive, cross-sectional study with a quantitative approach. The data collection was done in a teaching hospital, in the central zone of the city of São Paulo, in four Intensive Care Units, in 42 beds. For this, a socio-demographic and clinical characterization form was used for the patient and the CAM-ICU scale. Results: the sample consisted of eight patients, hospitalized in the adult ICU, during the collection period (30 days), with a mean age of 58.1 years (SD 20.3 years), 50% were men, with a personal history predominating Hypertension (87.5%), alcoholism, smoking and drug use (75%), hospitalized for neurological, cardiovascular, respiratory, digestive and metabolic problems in the use of devices such as tubes, catheters, and probes, which received sedation (75%) previously for up to seven days, presented a disturbance of attention (part 2A), 50% presented some type of marked form, for the item of attention disorder 2B, 62.5% did not present. In item 3A "disorganized thinking", the patient's thinking was disorganized or incoherent, with the dispersive or irrelevant conversation, 62.5% presented the disorder markedly and 37.5% mildly and of that sample, the behavior varied during the interview, that is, tended to increase the severity. In the item "disorientation", 75% of the patients were disoriented at the time of the interview, 50% had memory problems during the interview, such as inability to remember hospital events, or difficulty remembering given instructions and the others. In the item "perception disorder", the patient may present hallucinations, illusions or misinterpretations (thinking that some fixed object moved), 12.5% presented hallucination and 87.5% did not show signs of perception disturbance. In the evaluation of "psychomotor agitation", characterized by the abnormal increase of the motor activity, such as agitation, sudden change, frequent position, with evaluation of the abnormal decrease of the motor activity, such as lethargy, stare and empty and the permanence in the same position by a the results showed that 100.0% of the patients had an abnormal increase in motor activity, such as psychomotor agitation and 12.5%, with an abnormal decrease in motor activity and with death outcome in 50% of the patients in the sample. Conclusion: the present study concludes that the profile of patients with Delirium hospitalized in Adult Intensive Care Units, in this study, may not define in a specific way some characteristics as a trigger source of Delirium, because the sample is very small, however, the Clinical and socio-demographic characteristics of the patients, show similarities in relation to the patient with Delirium admitted to the ICU.