Sedative Agents and Prophylaxis in ICU Delirium

被引:0
作者
Norman B.C. [1 ]
Hughes C.G. [2 ]
机构
[1] Division of Pulmonary & Critical Care, Department of Medicine, Vanderbilt University School of Medicine, 1215 21st Ave. South, Suite 6000, Nashville, 37232, TN
[2] Division of Anesthesia Critical Care Medicine, Department of Anesthesiology, Vanderbilt University School of Medicine, 1211 21st Ave, 526 MAB, Nashville, 37212, TN
关键词
Delirium; Intensive care unit; Prevention; Risk factors; Treatment;
D O I
10.1007/s40140-014-0084-3
中图分类号
学科分类号
摘要
Delirium is a form of acute brain dysfunction in the critically ill that is associated with significant morbidity and mortality in addition to increases in healthcare costs. Important risk factors for delirium include a patient’s underlying illness, metabolic disturbances, sedative and psychoactive medications, and underlying cognitive impairment. Vigilant monitoring and recognition are the first step in reducing the burden of delirium. The Confusion Assessment Method for the ICU (CAM-ICU) and the Intensive Care Delirium Screening Checklist (IDCSC) are the validated methods of diagnosing delirium in the intensive care unit. Definitive evidence of treatments to reduce the incidence or duration of delirium in the intensive care unit is limited. Protocolized care to ensure minimization of sedation and appropriate sedative selection, early ventilator liberation, adequate treatment of pain, early mobility, and proper sleep hygiene offer the best hope of reducing the incidence of delirium and its burden on healthcare and society. © 2014, Springer Science + Business Media New York.
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页码:33 / 40
页数:7
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  • [41] Prakanrattana U., Prapaitrakool S., Efficacy of risperidone for prevention of postoperative delirium in cardiac surgery, Anaesth Intensive Care, 35, 5, pp. 714-719, (2007)
  • [42] Van den Boogaard M., Schoonhoven L., van Achterberg T., van der Hoeven J.G., Pickkers P., Haloperidol prophylaxis in critically ill patients with a high risk for delirium, Crit care, 17, 1, (2013)
  • [43] Pagevj, Gates E.E.W., Zhao S., Alce X.B., Shintani T., Jackson A., Perkins J., McAuley G.D.D.F., Effect of intravenous haloperidol on the duration of delirium and coma in critically ill patients (Hope-ICU): A randomised, double-blind, placebo-controlled trial, Lancet Respir Med, 1, 7, pp. 515-523, (2013)
  • [44] Page V.J., Davis D., Zhao X.B., Norton S., Casarin A., Brown T., Ely E.W., McAuley D.F., Statin use and risk of delirium in the critically ill, Am J Respir Crit Care Med, 189, 6, pp. 666-673, (2014)
  • [45] Morandi A., Hughes C.G., Thompson J.L., Pandharipande P.P., Shintani A.K., Vasilevskis E.E., Han J.H., Jackson J.C., Laskowitz D.T., Bernard G.R., Et al., Statins and delirium during critical illness: A multicenter, prospective cohort study, Crit Care Med, 42, 8, pp. 1899-1909, (2014)
  • [46] de Jonghe A., van Munster B.C., Goslings J.C., Kloen P., van Rees C., Wolvius R., van Velde R., Levi M., de Haan R.J., de Rooij S.E., Et al., Effect of melatonin on incidence of delirium among patients with hip fracture: A multicentre, double-blind randomized controlled trial, Can Med Assoc J, (2014)
  • [47] Dale C.R., Kannas D.A., Fan V.S., Daniel S.L., Deem S., Yanez N.D., Hough C.L., Dellit T.H., Treggiari M.M., Improved analgesia, sedation, and delirium protocol associated with decreased duration of delirium and mechanical ventilation, Ann Am Thorac Soc, 11, 3, pp. 367-374, (2014)
  • [48] Balasmc, Olsen V.E.E., Schmid K.M., Shostrom K.K., Cohen V., Peitz M.Z., Gannon G., Sisson D.E., Sullivan J.J., Et al., Effectiveness and safety of the awakening and breathing coordination, delirium monitoring/management, and early exercise/mobility bundle, Crit Care Med, 42, 5, pp. 1024-1036, (2014)
  • [49] Barr J., Fraser G.L., Puntillo K., Ely E.W., Gelinas C., Dasta J.F., Davidson J.E., Devlin J.W., Kress J.P., Joffe A.M., Et al., Clinical practice guidelines for the management of pain, agitation, and delirium in adult patients in the intensive care unit, Crit Care Med, 41, 1, pp. 263-306, (2013)
  • [50] Skrobik Y.K., Bergeron N., Dumont M., Gottfried S.B., Olanzapine vs haloperidol: treating delirium in a critical care setting, Intensive Care Med, 30, 3, pp. 444-449, (2004)