Introduction: Hospitalization of a patient in the intensive care unit (ICU) is one of the most stressful events, affecting not only the patient but also their close family members. This situation may lead to the development of anxiety and depressive symptoms, sleep disturbances, and, in some cases, even post-traumatic stress disorder (PTSD). In this context, increasing attention is being paid to the importance of psychological resilience—understood as an individual’s ability to effectively adapt to crisis situations and return to a state of relative emotional balance despite adversity. Methods: A scoping review method was used to map terms relevant to the resilience of family members of ICU patients. The aim of this study was to analyze current research on resilience among family members of patients in the intensive care unit (ICU), including measurement tools, facilitating factors, and psychological outcomes. Strict inclusion and exclusion criteria and the PCC framework were used to identify relevant studies. Results: The CD-RISC is the most used tool for assessing resilience in the families of ICU patients. Research suggests that resilience is associated with fewer symptoms of depression, anxiety, and acute stress. The studies indicate that spirituality, social/medical staff support, and involvement in care may be crucial factors for maintaining and increasing resilience. Some socio-demographic factors, such as gender, age, and previous mental disorders, may also influence the level of resilience. Conclusions: This scoping review highlights the need to implement measures aimed at strengthening the resilience of families of intensive care unit patients by promoting behaviors such as social/staff support and spirituality. Research suggests that levels of resilience may be associated with fewer psychological symptoms in family members of intensive care unit patients.

Background/Objective: Advances in intensive care medicine have substantially improved the survival of critically ill patients; however, they have also revealed the growing burden of neurological complications that affect both short-term outcomes and long-term functioning. Neurological complications in the intensive care unit (ICU) include a wide spectrum of disorders, ranging from acute brain dysfunction such as delirium, coma, and encephalopathy to persistent cognitive impairment after discharge, which represents a key component of Post-Intensive Care Syndrome (PICS). Delirium affects approximately one-third of ICU patients and is independently associated with increased mortality, prolonged hospitalization, and worse long-term neurocognitive outcomes. Due to the limited effectiveness of pharmacological therapies, current clinical approaches emphasize prevention, early diagnosis, and non-pharmacological strategies in line with PADIS guidelines. This narrative review aims to provide a clinically relevant synthesis of neurological complications in adult ICU patients, conceptualized as a continuum from acute brain dysfunction to long-term cognitive impairment. Methods: A narrative review of the literature was conducted, focusing on studies addressing epidemiology, pathophysiology, risk factors, diagnostic strategies, and prevention of neurological complications in critically ill adults. Attention was given to delirium, ICU-acquired cognitive impairment, and their association with PICS, as well as to current guideline-based and non-pharmacological interventions. Results: Available evidence indicates that neurological complications in the ICU are multifactorial and result from the interaction between patient vulnerability, severity of illness, systemic inflammation, sedative exposure, and environmental factors. Delirium remains the most common manifestation of acute brain dysfunction and is strongly associated with adverse outcomes. Increasing evidence supports the effectiveness of structured screening, early mobilization, sleep optimization, and multidisciplinary care bundles in reducing delirium incidence and duration. Moreover, growing attention is directed toward post-ICU follow-up and rehabilitation to reduce long-term cognitive decline. Conclusions: Neurological complications should be considered a central component of critical illness and a continuum extending beyond ICU discharge. Early identification of high-risk patients, implementation of preventive strategies, and integration of acute and post-ICU care are essential to improve survival and long-term cognitive outcomes. Further research should focus on personalized preventive and neuroprotective approaches in critically ill patients.

Introduction: Perioperative factors can significantly accelerate the development of sarcopenia in patients with aortic dissection, weakening their metabolic and functional reserves. Progressive sarcopenia after surgery is associated with a worse prognosis, increased mortality, and a higher risk of complications, which makes its early diagnosis and prevention key elements of care for this group of patients. Methods: The study included 116 patients hospitalized from April 2022 to May 2025 due to aortic dissection. Prospective studies were conducted using standardized tools as well as clinical data. The effect of blood transfusion, grip strength as measured with a hand dynamometer, and survival of patients after aortic dissection 3 months postoperatively were evaluated. Results: In the group of patients with a high risk of stroke, completely dependent and suffering from insomnia, transfusions were used significantly more often. SGA scores, CHA2DS2-VA score, and Barthel scale scores were dependent on the level of pain at discharge. Grip strength was significantly higher among patients who survived 3 months. The differences reached statistical significance on the second postoperative day. Conclusion: The results indicate that malnutrition is a key factor in the clinical condition of patients, increasing the risk of sarcopenia, stroke, and the severity of insomnia. At the same time, a higher degree of malnutrition is associated with reduced functional independence, which in turn affects the patient’s overall condition. The study found that malnutrition is a key factor in worsening the clinical condition of patients with aortic dissection, increasing the risk of sarcopenia, stroke and exacerbation of insomnia. The relationship between lower self-reliance and higher insomnia levels underscores the complex interplay among nutritional status, physical functioning, and sleep quality.

Introduction: Postoperative delirium, including emergence agitation, is recognized in the post-anesthesia care unit as a fluctuating disturbance of attention and cognition. The current evidence examined suggests that both anesthetic agents and postoperative pain intensity may influence the risk of delirium. The aim of this review is to discuss the significance of pharmacological agents used during anesthesia and the relationship between the intensity of postoperative pain and the occurrence of postoperative delirium in patients undergoing surgical procedures, regardless of age. Methods: A scoping review was conducted from December 2024 to December 2025. The articles identified in each search were limited to those published between 2015 and 2025. Results: Agents such as dexmedetomidine, remimazolam, and magnesium sulfate were examined in the included trials and were reported to be associated with reducing the incidence and severity of postoperative delirium, particularly in pediatric and elderly patients. Analysis of clinical trial outcomes conducted in pediatric populations undergoing various surgical procedures suggests that dexmedetomidine (administered intranasally and intravenously) and alfentanil were associated with lower incidence and severity of emergence delirium compared to standard care or other agents (e.g., midazolam). Higher doses of dexmedetomidine (2 µg/kg) were reported to be associated with improved postoperative analgesia and reduced agitation, without prolonging recovery time or causing serious adverse effects. Propofol, due to its rapid metabolism, was suggested to contribute to shorter emergence times; however, its impact on cognitive function requires further investigation. Additionally, there remains a lack of agreed-upon and/or validated tools and strategies for pain assessment in patients experiencing delirium. Conclusions: The current evidence examined suggests that the use of intranasal dexmedetomidine at appropriate doses may be associated with reduced postoperative pain and agitation without prolonging recovery time or increasing the risk of serious adverse events. Hydromorphone was reported in the included trials to be associated with better postoperative pain control than sufentanil, whereas remimazolam, although associated with reduced delirium incidence in some trials, did not influence the length of stay in the post-anesthesia care unit. Magnesium sulfate, although not significantly affecting the incidence of delirium, was associated with alleviation of postoperative symptoms such as pain and insomnia in adult patients. Ketamine, while commonly used for analgesic therapy, did not demonstrate a consistent association with delirium prevention and, in some studies, was associated with increased neuropsychiatric events. Further research is required to more precisely define optimal perioperative delirium prevention protocols.