Week 11: Confusion, delirium, and strokes

Topics to consider

• Causes of confusion and altered mental status on ICU

• Recognising and treating delirium

• Avoiding delirium to begin with

• Post-ICU survivor syndrome and follow up

• Stroke on the ICU – Risk factors and recognising it? What is malignant MCA syndrome? What is mechanical thrombectomy?

Resources

• Delirium in the critically ill (BJAEd)

• Delirium in the ICU and sleep and the ICU (LITFL)

• Delirium (IBCC)

• Perioperative stroke (BJAEd)

• Intensive care management and interventions for stroke (BJAEd)

• Malignant MCA syndrome (LITFL)

• Post-Intensive care syndrome (SCCM)

Key trials and guidelines

• Haloperidol and delirium: HOPE-ICU, MIND-USA, REDUCE

• Dexmed and delirium: in everyone (SPICE-3), in sepsis (DESIRE), just overnight, or in the elderly?

• Melatonin and delirium

• Thrombectomy vs thrombolysis: DIRECT-MT, DEFUSE-3, DAWN

• Late thrombolysis: EXTEND

• BP control post-stroke: MAPAS

Have we missed something?

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