Miller Russell R, Ely E Wesley
Division of Allergy, Pulmonary, and Critical Care Medicine, Center for Health Services Research, 6th Floor Medical Center East 6100, Vanderbilt University Medical Center, Nashville, TN 37232-8300, USA.
Curr Psychiatry Rep. 2007 Feb;9(1):26-34. doi: 10.1007/s11920-007-0006-x.
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 burdensome, 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.
谵妄是重症监护病房（ICU）中一种未得到充分认识且极为常见的器官功能障碍形式。了解ICU中谵妄的危险因素至关重要，其中一些因素是可以改变的。在过去5年中，一种用于检测重症患者谵妄的新工具已得到验证，并且被发现精神科医生和未接受精神科培训的人员在床边使用时也可靠。该工具即重症监护病房意识模糊评估法，已能够确定谵妄的严重后果，包括死亡率增加、成本更高、住院时间延长、拔管失败以及严重的长期认知障碍。本文回顾了谵妄的预防和治疗选择以及当前的药物和非药物治疗方法，同时承认迄今为止证据质量有限但正在改善。
