<<snip>>
patients with indicators of oxidative dysfunction developed delirium
more frequently,
<<snip>>

Psychosomatics 47:56-61, February 2006
doi: 10.1176/appi.psy.47.1.56
© 2006 Academy of Psychosomatic Medicine

Delirium

Syndromes Secondary to General Medical Disorders

Impaired Oxidative Metabolism Precipitates Delirium: A Study of 101 ICU
Patients
Jeff S. Seaman, M.S., M.D., Jason Schillerstrom, M.D., David Carroll,
R.N., M.S.N., and Thomas M. Brown, M.D.
Received July 13, 2004; revised February 14, 2005; accepted March 7,
2005. From the University of Oklahoma Health Sciences Center (JSS); the
Department of Psychiatry, University of Texas Health Sciences Center,
San Antonio (JS); Wilford Hall Medical Center, Lackland Air Force Base,
TX (DC); and the Department of Psychiatry, Audrey Murphy Veterans
Hospital, San Antonio, TX (TMB). Address correspondence and reprint
requests to Dr. Seaman, OUHSC Dept of Psychiatry, P.O. Box 26901, OK
City, OK 73190. e-mail: jeff-seaman@ouhsc.edu

Data from 101 consecutively admitted intensive care unit (ICU) patients
were examined to determine whether oxidative metabolic stress existed
within the 48 hours before delirium onset. The occurrence of pneumonia
and sepsis at any time during hospitalization was also recorded.
Delirium was defined retrospectively with the Confusion Assessment
Method (CAM). Older patients were found to develop delirium more
frequently than younger patients. There were no differences in illness
severity (APACHE II) between those who developed delirium and those who
did not. Three measures of oxygenation (hemoglobin, hematocrit, pulse
oximetry) were worse in the patients who later developed delirium. Two
measures of oxidative stress (sepsis, pneumonia) occurred more
frequently among those diagnosed with delirium. Hence, patients with
indicators of oxidative dysfunction developed delirium more frequently,
and this was not linked to illness severity.

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