AccessMedicine's Case of the Week: ICU Delirium

From: Resident Readiness: Internal Medicine
AccessMedicine's Case of the Week: ICU Delirium


A 75-year-old woman with a history of chronic obstructive pulmonary disease is evaluated in the intensive care unit (ICU) for altered mental status. She had a repair of an aortic dissection and was extubated uneventfully. Three days later she developed changes in her mental status. In the ICU, she became agitated, pulling at her lines, attempting to climb out of bed, and asking to leave the hospital. Her arterial blood gas values are normal. The patient has no history of alcohol abuse. Calm reassurance and presence of family members have done little to reduce the patient's agitated behavior.


1. What is the diagnosis for the patient's altered mental status?

2. What is the most appropriate therapy for this patient's altered mental status?

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