C. Adrian Austin, MD, MSCR, Assistant Professor of Medicine in the Division of Pulmonary and Critical Care, is a co-author of the newly published “Executive Summary: Society of Critical Care Medicine Guidelines on Caring for Older Adults in the ICU,“ appearing in Critical Care Medicine.
The guidelines were developed by a multidisciplinary panel convened by the Board of the American College of Critical Care Medicine. The group conducted a systematic review of the scientific literature to produce evidence-based recommendations for the care of critically ill older adults, a population that has composed more than half of all ICU days in the United States for the past 25 years.
The panel issued two conditional recommendations:
1. Geriatric Model of Care The panel suggests a geriatric model of care for all older adults admitted to the ICU. This may include removal of unnecessary medical devices, addressing sensory impairments such as hearing loss, and improving functional and cognitive outcomes through occupational therapy. Importantly, this model can be implemented without a dedicated geriatrician, making it broadly applicable across institutions.
2. Antipsychotic Medications and Delirium Prevention The panel suggests against using antipsychotic medications, specifically haloperidol and quetiapine, for the prevention of delirium in critically ill older adults, citing concern about their known risks in this population.
Both recommendations are classified as conditional, reflecting the current state of evidence and the need for clinicians to consider each patient’s individual values and circumstances.
Read the full publication here.