Acute Brain Failure: Pathophysiology, Diagnosis, Management, and Sequelae of Delirium

Abstract

Delirium is the most common psychiatric syndrome found in the general hospital setting, with an incidence as high as 87% in the acute care setting. Delirium is a neurobehavioral syndrome caused by the transient disruption of normal neuronal activity secondary to systemic disturbances. The development of delirium is associated with increased morbidity, mortality, cost of care, hospital-acquired complications, placement in specialized intermediate and long-term care facilities, slower rate of recovery, poor functional and cognitive recovery, decreased quality of life, and prolonged hospital stays. This article discusses the epidemiology, known etiological factors, presentation and characteristics, prevention, management, and impact of delirium.

Keywords: Acute brain failure; Delirium; Encephalopathy; ICU-psychosis; Network dysregulation; Neurotransmitter dysfunction; Post-operative delirium; Systems integration failure hypothesis.