Delirium management in neurointensive care in the Czech Republic - a survey

Delirium is a phenotypic syndrome that is difficult to detect in the intensive care. In neurointensive care, the symptoms of delirium overlap with those of primary brain injury. At the same time, delirium is a predictive factor of higher morbidity and mortality and is often a sign of untreated extracerebral dysfunction or disease like sepsis, metabolic disturbance, and pharmacotherapy combined with immobilization. Thus, the monitoring of delirium in the neurointensive care is an important part of therapy and improvement of patients' prognosis. Currently, there are validated tests with a relatively high validity and predictive value also in the Czech language. One of the diagnostic pitfalls, so far, is inadequate differential diagnosis of nonconvulsive epileptic status. In the survey, we focused on delirium management in neurointensive care in the Czech Republic. We have found sufficient awareness of the severity of delirium and its other consequences. On the other hand, its systematic monitoring, which is recommended, appears to be a persistent problem in our inpatient care.