• Pratik P Pandharipande, E Wesley Ely, Rakesh C Arora, Michele C Balas, Malaz A Boustani, La CalleGabriel HerasGHInternational Research Project Humanizing Intensive Care (Proyecto HU-CI), Intensive Care Unit, Hospital Universitario de Torrejón, Madrid, Spain., Colm Cunningham, John W Devlin, Julius Elefante, Jin H Han, Alasdair M MacLullich, José R Maldonado, Alessandro Morandi, Dale M Needham, Valerie J Page, Louise Rose, SalluhJorge I FJIFDepartment of Critical Care, rD' OR Institute for Research and Education and Post-Graduate Program Federal University of Rio de Janeiro, Rio de Janeiro, Brazil., Tarek Sharshar, Yahya Shehabi, Yoanna Skrobik, SlooterArjen J CAJCDepartment of Intensive Care Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands., and SmithHeidi A BHABDivision of Pediatric Cardiac Anesthesia, Department of Anesthesiology and Pediatrics, Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, TN, USA..
• Division of Anesthesiology Critical Care Medicine, Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN, USA. Pratik.pandharipande@vanderbilt.edu.
• Intensive Care Med. 2017 Sep 1; 43 (9): 132913391329-1339.

AbstractDelirium, a prevalent organ dysfunction in critically ill patients, is independently associated with increased morbidity. This last decade has witnessed an exponential growth in delirium research in hospitalized patients, including those critically ill, and this research has highlighted that delirium needs to be better understood mechanistically to help foster research that will ultimately lead to its prevention and treatment. In this invited, evidence-based paper, a multinational and interprofessional group of clinicians and researchers from within the fields of critical care medicine, psychiatry, pediatrics, anesthesiology, geriatrics, surgery, neurology, nursing, pharmacy, and the neurosciences sought to address five questions: (1) What is the current standard of care in managing ICU delirium? (2) What have been the major recent advances in delirium research and care? (3) What are the common delirium beliefs that have been challenged by recent trials? (4) What are the remaining areas of uncertainty in delirium research? (5) What are some of the top study areas/trials to be done in the next 10 years? Herein, we briefly review the epidemiology of delirium, the current best practices for management of critically ill patients at risk for delirium or experiencing delirium, identify recent advances in our understanding of delirium as well as gaps in knowledge, and discuss research opportunities and barriers to implementation, with the goal of promoting an integrated research agenda.

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