Study ID’s Biomarkers Tied to Delirium in Critically Ill Patients
A new study has identified blood-based biomarkers associated with both delirium duration and severity in critically ill patients.
An estimated 7 million hospitalized Americans suffer from the acute confusion and disorientation of delirium, including a majority of patients in medical or surgical intensive care units (ICUs).
Patients who develop delirium in the ICU are more likely to experience complications, longer stays and have a higher risk of readmission. They are also more likely to experience cognitive impairment, and they face a greater risk of death for up to a year after their hospital stay compared to ICU patients without delirium.
The new finding opens the door to easy, early identification of individuals at risk for delirium and could potentially lead to new treatments of this condition for which drugs have been shown to be largely ineffective.
“If you can tell which patients will have higher delirium severity and longer duration and therefore greater probability of death, there are important treatment implications,” said Babar Khan, M.D., who led the research and is the president of the American Delirium Society.
“Analyzing biomarkers to stratify risk for delirium is a promising approach with the potential to be applied regularly in ICU patients in the near future,” said Khan, Regenstrief Institute research scientist and Indiana University (IU) School of Medicine faculty member.
In the study, the team reports that biomarkers for the activation of glial cells (support cells that surround neurons) and astrocytes (star-shaped glial cells in the brain and spinal cord) as well as for inflammation were associated with increased delirium duration and severity and greater in-hospital mortality.
Biomarkers of the 321 study participants, all of whom experienced delirium in an ICU, were identified from samples obtained through simple blood draws.
Delirium severity was determined using a tool developed by a team including Regenstrief, IU School of Medicine and Purdue College of Pharmacy scientists. The CAM-ICU-7, short for Confusion Assessment Method for the Intensive Care Unit 7, is easy to administer, even to patients on mechanical ventilators.
Each day with delirium in the ICU is tied to a 10 percent greater risk of death, according to Khan, so diminishing its duration and ultimately preventing it is critical. Research has shown that antipsychotics, such as the widely used haloperidol, are not effective for the management of delirium duration or severity.
The research team is actively exploring other approaches to delirium. Khan is co-principal investigator of an ongoing study that is the first to test whether listening to music, a non-pharmacological strategy that has been shown to decrease over-sedation, anxiety and stress in critically ill patients — all factors that predispose to ICU delirium — and reduces the odds of developing delirium.
The findings are published in the journal Critical Care Medicine.
Source: Regenstrief Institute
Pedersen, T. (2020). Study ID’s Biomarkers Tied to Delirium in Critically Ill Patients. Psych Central. Retrieved on September 27, 2020, from https://psychcentral.com/news/2020/02/09/study-ids-biomarkers-tied-to-delirium-in-critically-ill-patients/153618.html