Diagnosis and management of delirium in critical care patients: a French national survey

Purpose: Delirium has severe consequences on hospital mortality, length of stay, costs, and long-term cognitive function. No study has ever investigated French intensivists' attitude, a basis for management improvement. We conducted a national survey to describe the attitudes of French intensivists toward delirium screening and management. Methods: A questionnaire was sent by e-mail to the intensivists of the French intensive care society. Up to three e-mails have been sent to nonrespondents during a 75-day period. Results: The response rate was 25.7% (n = 283). Twenty-eight respondents (10%) reported screening for delirium with a validated screening tool. Among respondents, 60% estimated that delirium occurs in less than 25% of intubated patients. Antipsychotics, benzodiazepines, and hydroxizine were prescribed as first-line therapy in 77%, 53%, and 36% of the cases, respectively. Mobilization of intubated patients occurred less frequently than estimated as possible. Physicians who screened for delirium had a higher estimation of its severity and occurrence than physicians who did not. Conclusions: Respondents among French intensivists rarely screen for delirium with a dedicated tool. Treatments reported as used in that setting are often different from the guidelines.