A Randomised Placebo-controlled Double-blind Exploratory Trial Within Cohort Using Wheat Beer for Prevention of Delirium in Intensive Care Patients

Delirium

Delirium is a complex state of confusion that can be seen as an acute failure of brain function. It is characterised by fluctuating deficits in cognition and attention, dysregulation of emotions and circadian rhythm as well as psychomotor changes.

In intensive care units (ICU) delirium is the most frequent syndromic complication with a prevalence between 26 - 60%. In mechanically ventilated patients, delirium is even detected in more than 80%. In elective cardiac surgery patients admitted to the ICU for postoperative monitoring postoperative delirium presents as a major complication and occurs in up to 33.5%. Hypoactive delirium outperforms the other two types - hyperactive and mixed - by far.

Occurrence of delirium is associated with several negative repercussions: Delirious patients show higher prevalence in morbidity and mortality, longer stays in intensive care units and the regular ward, as well as impaired cognitive function even months after the acute illness. The intensity of impairment in cognitive and executive function correlates with the duration of delirium. Furthermore, delirious patients cause major additional costs of up to 20% more compared to non-delirious patients.

Although there are several approaches for prevention of deliria in ICUs they are still highly prevalent causing a high and versatile burden as mentioned above. The several mainly pharmacological treatment approaches are more to be seen as a symptomatic treatment than a causal treatment. No groundbreaking prevention or treatment strategy has been found so far. Therefore, improvement of existing and development of new prevention strategies is therefore crucial and highly necessary. Further it has to be shown if prevention of delirium has an effect on clinical outcome.