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
[11]  
Williams-Russo P., Urquhart B.L., Sharrock N.E., Charlson M.E., Post-operative delirium: Predictors and prognosis in elderly orthopedic patients, J Am Geriatr Soc, 40, pp. 759-767, (1992)
[12]  
Inouye S.K., Bogardus Jr. S.T., Charpentier P.A., Et al., A multi-component intervention to prevent delirium in hospitalized older patients, N Engl J Med, 340, pp. 669-676, (1999)
[13]  
Cole M.G., Dendukuri N., McCusker J., Han L., An empirical study of different diagnostic criteria for delirium among elderly medical inpatients, J Neuropsychiatry Clin Neurosci, 15, pp. 200-207, (2003)
[14]  
Kishi Y., Iwasaki Y., Takezawa K., Et al., Delirium in critical care unit patients admitted through an emergency room, Gen Hosp Psychiatry, 17, pp. 371-379, (1995)
[15]  
Aldemir M., Ozen S., Kara I.H., Et al., Predisposing factors for delirium in the surgical intensive care unit, Crit Care, 5, pp. 265-270, (2001)
[16]  
Ely E.W., Inouye S.K., Bernard G.R., Et al., Delirium in mechanically ventilated patients: Validity and reliability of the confusion assessment method for the intensive care unit (CAM-ICU), JAMA, 286, pp. 2703-2710, (2001)
[17]  
Ely E.W., Margolin R., Francis J., Et al., Evaluation of delirium in critically ill patients: Validation of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU), Crit Care Med, 29, pp. 1370-1379, (2001)
[18]  
Dubois M.J., Bergeron N., Dumont M., Et al., Delirium in an intensive care unit: A study of risk factors, Intensive Care Med, 27, pp. 1297-1304, (2001)
[19]  
Bergeron N., Dubois M.J., Dumont M., Et al., Intensive Care Delirium Screening Checklist: Evaluation of a new screening tool, Intensive Care Med, 27, pp. 859-864, (2001)
[20]  
Rincon H.G., Granados M., Unutzer J., Et al., Prevalence, detection and treatment of anxiety, depression, and delirium in the adult critical care unit, Psychosomatics, 42, pp. 391-396, (2001)
123456789