Which factor increases delirium risk in ICU patients?

Which factor increases delirium risk in ICU patients?

• A. Prolonged bed rest without movement
• B. Adequate sleep hygiene
• C. Psychoactive drugs, particularly benzodiazepines
• D. Early mobility

Answer: (C)

Psychoactive drugs, especially benzodiazepines, raise delirium risk in the ICU because they strongly dampen brain arousal and alter neurotransmitter balance in a vulnerable critically ill system. Benzodiazepines boost GABA activity, leading to slowed processing, impaired attention and orientation, and a higher likelihood of developing delirium. In the ICU, these effects can be prolonged by organ dysfunction and drug accumulation, and stopping them abruptly can trigger withdrawal delirium. Because delirium is linked to worse outcomes like longer ventilation and longer ICU stays, clinicians aim to minimize benzodiazepine exposure and use lighter, shorter-acting strategies when possible. While good sleep hygiene and early mobility help protect against delirium, prolonged bed rest without movement also contributes to delirium risk, making the sedative effect of benzodiazepines the strongest modifiable factor among the options.

Psychoactive drugs, especially benzodiazepines, raise delirium risk in the ICU because they strongly dampen brain arousal and alter neurotransmitter balance in a vulnerable critically ill system. Benzodiazepines boost GABA activity, leading to slowed processing, impaired attention and orientation, and a higher likelihood of developing delirium. In the ICU, these effects can be prolonged by organ dysfunction and drug accumulation, and stopping them abruptly can trigger withdrawal delirium. Because delirium is linked to worse outcomes like longer ventilation and longer ICU stays, clinicians aim to minimize benzodiazepine exposure and use lighter, shorter-acting strategies when possible.

While good sleep hygiene and early mobility help protect against delirium, prolonged bed rest without movement also contributes to delirium risk, making the sedative effect of benzodiazepines the strongest modifiable factor among the options.