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ICU Psychosis
(Intensive Care Unit Psychosis)

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Medical Author:

Maureen Welker, MSN, NPc, CCRN

Maureen Welker, MSN, NPc, CCRN

Maureen Welker received a Bachelor of Science degree from California State University, Long Beach (CSULB) and also obtained a Public Health Nurse Certification. There she served as Vice President of the Graduate Nurses Association, at CSULB and also served as President of the Graduate Nurses Association. Ms. Welker is a board-certified Nurse Practitioner and is currently on staff at Mission Hospital Regional Medical Center.

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Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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What is ICU psychosis?

ICU psychosis is a disorder in which patients in an intensive care unit (ICU) or a similar setting experience a cluster of serious psychiatric symptoms. Another term that may be used interchangeably for ICU psychosis is ICU syndrome. ICU psychosis is also a form of delirium, or acute brain failure.

What causes ICU psychosis?

Environmental Causes

• Sensory deprivation: A patient being put in a room that often has no windows, and is away from family, friends, and all that is familiar and comforting.

• Sleep disturbance and deprivation: The constant disturbance and noise with the hospital staff coming at all hours to check vital signs, give medications, etc.

• Continuous light levels: Continuous disruption of the normal biorhythms with lights on continually (no reference to day or  night).

• Stress: Patients in an ICU frequently feel the almost total loss of control over their life.

• Lack of orientation: A patient's loss of time and date.

• Medical monitoring: The continuous monitoring of the patient's vital signs, and the noise monitoring devices produce can be disturbing and create sensory overload.

Medical Causes

• Pain which may not be adequately controlled in an ICU

• Critical illness: The pathophysiology of the disease, illness or traumatic event - the stress on the body during an illness can cause a variety of symptoms.

• Medication (drug) reaction or side effects: The administration of medications typically given to the patient in the hospital setting that they have not taken before.

• Infection creating fever and toxins in the body.

• Metabolic disturbances: electrolyte imbalance, hypoxia (low blood oxygen levels), and elevated liver enzymes.

• Heart failure (inadequate cardiac output)

• Cumulative analgesia (the inability to feel pain while still conscious)

• Dehydration