Prolonged Refractory ICU Delirium Successfully Treated With Valproic Acid: Case Report and Literature Review.
Bibidh SubediPatricia R LouzonAhmed MasoodStephanie RecksieckPublished in: Journal of pharmacy practice (2020)
Intensive care unit (ICU) delirium is characterized by acute onset of cerebral dysfunction with a change or fluctuation in baseline mental status. Delirium management includes non-pharmacologic and pharmacologic treatment. However at times, alternative pharmacologic treatment is warranted. Valproic acid (VPA) is a potential pharmacologic agent that can be utilized to treat ICU delirium, though there is a paucity of evidence for its use, especially in patients with a history of substance abuse. We review the literature on VPA use in ICU delirium, and describe a challenging case of a 27-year-old female with a history of substance abuse experiencing hyperactive ICU delirium for greater than a month, refractory to multiple treatment modalities, and successfully treated with VPA therapy.
Keyphrases
- intensive care unit
- cardiac surgery
- mechanical ventilation
- hip fracture
- systematic review
- stem cells
- oxidative stress
- combination therapy
- subarachnoid hemorrhage
- mesenchymal stem cells
- bone marrow
- risk assessment
- respiratory failure
- acute respiratory distress syndrome
- drug induced
- extracorporeal membrane oxygenation
- intimate partner violence
- aortic dissection