Section 5: Conclusions (from DOI: 10.1186/s13054-020-02882-x)

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Article	COVID-19: ICU delirium management during SARS-CoV-2 pandemic
Sections in this Publication
Section	Section 1: Introduction (from DOI: 10.1186/s13054-020-02882-x)
Section	Section 2: COVID-19: Potential factors contributing to ICU delirium (from DOI: 10.1186/s13054-020-02882-x)
Section	Section 3: COVID-19: Neuro-invasive potential of SARS-nCoV-2 as cause of delirium (from DOI: 10.1186/s13054-020-02882-x)
Section	Section 4: COVID-19: ICU delirium management:potential problems and solutions (from DOI: 10.1186/s13054-020-02882-x)
Section	Section 5: Conclusions (from DOI: 10.1186/s13054-020-02882-x)
Section	Authors' contributions (from DOI: 10.1186/s13054-020-02882-x)
Section	Funding (from DOI: 10.1186/s13054-020-02882-x)
Section	Availability of data and materials (from DOI: 10.1186/s13054-020-02882-x)
Section	Ethics approval and consent to participate (from DOI: 10.1186/s13054-020-02882-x)
Section	Consent for publication (from DOI: 10.1186/s13054-020-02882-x)
Section	Competing interests (from DOI: 10.1186/s13054-020-02882-x)
Section	References (from DOI: 10.1186/s13054-020-02882-x)
Named Entities in this Section
Entity	2019 novel coronavirus (species)
Entity	Human (species)
Entity	Delirium (disease - MeSH descriptor)
Entity	Brain Diseases (disease - MeSH descriptor)
Entity	Infections (disease - MeSH descriptor)
Entity	Multiple Organ Failure (disease - MeSH descriptor)
Entity	Coma (disease - MeSH descriptor)
Dataset	Pubtator Central BioC-JSON formatted article files

From publication: "COVID-19: ICU delirium management during SARS-CoV-2 pandemic" published as Crit Care; 2020 04 28 ; 24 (1) 176. DOI: https://doi.org/10.1186/s13054-020-02882-x

Section 5: Conclusions

Data regarding delirium in the SARS-CoV-2 pandemic era are thus far too limited. This virus destroys the respiratory tract and invades the CNS, both of which will produce an extremely high-risk circumstance for both acute and long-term brain dysfunction in patients infected with the COVID-19 virus. The further elements of human isolation, extended time away from family and other loved ones, and other elements of care all form what could be construed as a delirium factory that medical teams must address. In the patients with COVID-19, delirium can be a manifestation of direct CNS invasion, induction of CNS inflammatory mediators, secondary effects of other organ system failure, and untoward medical and environmental factors including heavy use of sedatives for prone positioning of the patient and quarantining and social isolation during care. The focus during the COVID-19 pandemic obviously lies within the dire necessity of organizational issues, i.e., lack of ventilators, shortage of personal protection equipment, resource allocation, prioritization of limited mechanical ventilation options, end-of-life care. It is precisely during such times that standardization of safety concerns encapsulated in the ABCDEF bundle can provide a framework to help us accomplish "whole person" care that will help with acute management success as well as improvement of long-term survivorship and reductions of PICS and PICS-F burden on individuals and society as a whole. At the heart of this safety bundle lies the brain, the most vital organ of the human body, and it has been shown now in over 25,000 patients that higher compliance yields better survival, less delirium and coma, shorter lengths of stay, less ICU bounce-back, and lower cost of care. Implementation at the bedside of excellent delirium prevention and management should be a priority during the COVID-19 pandemic.