Incidence of delirium in critically ill patients on mechanical ventilation receiving nonpharmacological measures

Luis A. Martínez-Cabrera, Departamento de Enfermería del Adulto en Estado Crítico, Centro Médico Naval, Secretaría de Marina, Ciudad de México, México
Joel Martínez-Martínez, Departamento de Enfermería del Adulto en Estado Crítico, Centro Médico Naval, Secretaría de Marina, Ciudad de México, México

Introduction: Delirium is a neuropsychiatric disorder of multifactorial origin. Its incidence in intensive care units is between 60-80%, and is potentially reversible with non-pharmacological intervention programs in 30-40% of cases. Objective: To determine the difference in the incidence of delirium in critical patients subjected to mechanical ventilation who receive non-pharmacological measures compared to a historical control of patients who did not receive them, in the adult intensive care unit of a hospital in Mexico City. Method: Observational, comparative, longitudinal and ambispective study. A package of ABCDEF measures with non-pharmacological interventions was designed and applied. We worked with a historical control group and an intervention group of 42 patients each, identifying the occurrence of delirium with the CAM-ICU scale. Results: 33.3% of the sample was on mechanical ventilation for more than 96 hours. In the intervention group, 24 people (57.1%) developed delirium, and in the control group there were 30 (71.4%); this is a statistically significant decrease (p = 0.027). We found coincidence with other studies, which demonstrated preventive effects and statistically significant differences in the reduction of delirium. Conclusions: The relevance of non-pharmacological approaches as an integral part of the care of critically ill patients that could be considered as an effective strategy to reduce delirium in this population is highlighted.

Keywords: Delirium. Mechanical ventilation. Nonpharmacological treatment.