Published online by Cambridge University Press: 24 July 2019
Acute confusional state (ACS) is very common in the intensive care unit (ICU) setting. Most often, it is one of the main reasons a neurology consult is requested in the surgical or medical ICU. Acute confusional states are often used interchangeably when describing metabolic encephalopathy, delirium, ICU psychosis, or septic encephalopathy. Encephalopathy is defined as a subacute global brain dysfunction that is gradual in onset with very broad clinical symptoms, whereas delirium is often described as an acute process. The list of potential causes (Table 32.1) of ACS could be summarized using “Vitamin E” as a mnemonic. In this chapter, we will only focus on management of delirium and toxic metabolic encephalopathy.