Delirium and Coronavirus Disease 2019: Looking Back, Moving Forward

Kelly M Potter; Brenda T Pun; Kerri Maya; Bethany Young; Stacey Williams; Marc Schiffman; Annmarie Hosie; Leanne M Boehm

doi:10.1016/j.cnc.2023.12.003

Delirium and Coronavirus Disease 2019: Looking Back, Moving Forward

Crit Care Nurs Clin North Am. 2024 Sep;36(3):415-426. doi: 10.1016/j.cnc.2023.12.003. Epub 2024 Jan 2.

Authors

Kelly M Potter¹, Brenda T Pun², Kerri Maya³, Bethany Young⁴, Stacey Williams⁵, Marc Schiffman⁶, Annmarie Hosie⁷, Leanne M Boehm⁸

Affiliations

¹ Department of Critical Care Medicine, CRISMA Center, University of Pittsburgh, Pittsburgh, PA, USA. Electronic address: kelly.potter@pitt.edu.
² Department of Medicine, Pulmonary and Critical Care, Critical Illness, Brain Dysfunction, and Survivorship Center, Vanderbilt University Medical Center, Nashville, TN, USA.
³ Sutter Health System, Sacramento, CA, USA.
⁴ Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
⁵ Monroe Carrell Jr Children's Hospital at Vanderbilt, Nashville, TN, USA.
⁶ Weill Cornell Medicine, New York, NY, USA.
⁷ School of Nursing & Midwifery Sydney, University of Notre Dame Australia, Sydney, New South Wales, Australia; Cunningham Centre for Palliative Care, St Vincent's Health Network Sydney, Sydney, New South Wales, Australia; IMPACCT- Improving Palliative, Aged and Chronic Care Through Research and Translation, University of Technology Sydney, Sydney, New South Wales, Australia.
⁸ School of Nursing, Vanderbilt University, Nashville, TN, USA; Critical Illness, Brain Dysfunction, and Survivorship (CIBS) Center, Vanderbilt University Medical Center, Nashville, TN, USA.

Abstract

During the coronavirus disease 2019 pandemic, crisis changes in clinical care increased rates of delirium in the intensive care unit (ICU). Deep sedation, unfamiliar environments with visitor restrictions, and such factors due to high workload and health system strain contributed to the occurrence of delirium doubling in the ICU. As the pandemic wanes, health care systems and ICU leadership must emphasize post-pandemic recovery, integrating lessons learned about delirium management, evidence-based care, and family involvement. Strategies to empower clinicians, creatively deliver care, and integrate families pave the way forward for a more holistic approach to patient care in the post-pandemic era.

Keywords: ABCDEF bundle; COVID-19; Delirium; Family engagement.

Publication types

Review

MeSH terms

COVID-19* / epidemiology
Critical Care Nursing
Delirium* / epidemiology
Delirium* / therapy
Humans
Intensive Care Units*
SARS-CoV-2

Grants and funding

T32 HL007820/HL/NHLBI NIH HHS/United States