Delirium and cognitive dysfunction in the intensive care unit

被引：6
作者：
Miller III R.R. [1 ]
Ely E.W. [1 ]
机构：
[1] Division of Allergy, Pulmonary, and Critical Care Medicine, Center for Health Services Research, Vanderbilt University Medical Center, Nashville, TN 37232-8300
来源：
Current Psychiatry Reports | 2007年 / 9卷 / 1期
基金：
美国国家卫生研究院;
关键词：
Intensive Care Unit; Haloperidol; Confusion Assessment Method; Richmond Agitation Sedation Scale; Delirious Patient;
D O I：
10.1007/s11920-007-0006-x
中图分类号：
学科分类号：
摘要：
Delirium is an under-recognized, highly prevalent form of organ dysfunction: in the intensive care unit (ICU). It is imperative to be aware of risk factors for delirium in the ICU, some of which are modifiable. In the last 5 years, a new tool for detecting delirium among critically ill patients has been validated and found reliable for use at the bedside by psychiatrists and nonpsychiatrically trained personnel as well. The tool, the Confusion Assessment Method for the Intensive Care Unit, has enabled determination of the serious sequelae of delirium, including increased mortality, higher cost, longer length of hospital stay, failure of extubation, and burdensonme, long-term cognitive impairment. This article reviews prevention and treatment options, and current pharmacologic and nonpharmacologic approaches to delirium, acknowledging limited but improving quality of evidence to date. Copyright © 2007 by Current Medicine Group LLC.
引用
收藏
页码：26 / 34
页数：8
相关论文
共 84 条
[1]  
Jacobi J., Fraser G.L., Coursin D.B., Et al., Clinical practice guidelines for the sustained use of sedatives and analgesics in the critically ill adult, Crit Care Med, 30, pp. 119-141, (2002)
[2]  
Ely E.W., Siegel M.D., Inouye S.K., Delirium in the intensive care unit: An under-recognized syndrome of organ dysfunction, Semin Respir Crit Care Med, 22, pp. 115-126, (2001)
[3]  
Meagher D.J., Hanlon D.O., Mahony E.O., Et al., Relationship between symptoms and motoric subtype of delirium, J Neuropsychiatry Clin Neurosci, 12, pp. 51-56, (2000)
[4]  
Lipowski Z.J., Delirium: Acute Confusional States, (1990)
[5]  
Peterson J.F., Pun B.T., Dittus R., Et al., Delirium and its motoric subtypes: A study of 614 critically ill patients, J Am Geriatr Soc, 54, pp. 479-484, (2006)
[6]  
Inouye S.K., Van Dyck C.H., Alessi C.A., Et al., Clarifying confusion: The confusion assessment method. A new method for detection of delirium, Ann Intern Med, 113, pp. 941-948, (1990)
[7]  
Diagnostic and Statistical Manual of Mental Disorders, (1987)
[8]  
Laurila J.V., Pitkala K.H., Strandberg T.E., Tilvis R.S., Delirium among patients with and without dementia: Does the diagnosis according to the DSM-IV differ from the previous classifications?, Int J Geriatr Psychiatry, 19, pp. 271-277, (2004)
[9]  
O'Keeffe S., Lavan J., The prognostic significance of delirium in older hospital patients, J Am Geriatr Soc, 45, pp. 174-178, (1997)
[10]  
Levkoff S.E., Evans D.A., Liptzin B., Et al., Delirium. The occurrence and persistence of symptoms among elderly hospitalized patients, Arch Intern Med, 152, pp. 334-340, (1992)
123456789