title: Managing ICU delirium.
abstract: OBJECTIVE
  ICU delirium is a common and serious acute brain dysfunction with adverse outcome and high risk of mortality. The awareness of ICU delirium as a problem, which immediately requires therapeutic intervention, has been increased in the past years. This article aims to provide information in order to increasingly modify the management of this severe problem, that is, its detection, prevention, and treatment toward algorithm-based and protocol-driven procedures.
  
  
  RESULTS
  The bundle of target-controlled and protocol-driven management of sedation, analgesia, and delirium and its monitoring included in this work offer the opportunity to improve the outcome of ICU patients based on the best evidence available to date. Moreover, the knowledge about precipitating and predisposing factors to prevent ICU delirium is essential and is represented in this review. Unresolved seems the pharmacological therapy of delirium because of the contradictory results of research published so far, especially regarding neuroleptics and cholinesterase inhibitors.
  
  
  CONCLUSIONS
  The management of ICU delirium must be a key aspect to improve the outcome of critically ill patients. The development of pharmacological treatment strategies and deeper understanding of the underlying pathophysiology will require further research.
authors.affiliation: Department of Anaesthesiology and Intensive Care Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Schiemann
authors.forename: Daniel
authors.initials: D
authors.lastname: Hadzidiakos
authors.forename: Claudia
authors.initials: C
authors.lastname: Spies
mesh_terms: D003693:Delirium / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D007362:Intensive Care Units; D010146:Pain / Q000188:drug therapy; D010147:Pain Measurement; D012307:Risk Factors; D016896:Treatment Outcome