Heymann Anja, Spies Claudia
Klinik für Anästhesiologie mit Schwerpunkt operative Intensivmedizin der Charité.
Anasthesiol Intensivmed Notfallmed Schmerzther. 2010 Feb;45(2):112-6; quiz 117. doi: 10.1055/s-0030-1248146. Epub 2010 Feb 12.
To date, there are few studies available focusing on prevention and therapy of delirium in ICU patients. Monitoring during routine care is important because without using validated tools only one third of the delirious patients will be detected. A lot of non-pharmacological interventions like re-orientation and helping the patient to get back his autonomy, but also goal-orientated sedation support prevention and therapy of delirium. Furthermore, there are hints that pharmacological intervention can reduce incidence and severity of delirium. For delirium prevention there are drugs available acting on different receptor systems (acetylcholine, dopamine, opioid, glutamate). For the use of this drugs, a strict risk-benefit-consideration is necessary due to the low level of evidence of the existing studies. Therapeutically causative and symptom-orientated approaches should be preferred.
迄今为止，针对重症监护病房（ICU）患者谵妄的预防和治疗的研究很少。常规护理期间的监测很重要，因为如果不使用经过验证的工具，只有三分之一的谵妄患者会被检测出来。许多非药物干预措施，如重新定向和帮助患者恢复自主能力，以及目标导向镇静，都有助于谵妄的预防和治疗。此外，有迹象表明药物干预可以降低谵妄的发生率和严重程度。对于谵妄的预防，有作用于不同受体系统（乙酰胆碱、多巴胺、阿片类、谷氨酸）的药物可供使用。由于现有研究的证据水平较低，在使用这些药物时，必须进行严格的风险效益考量。治疗上应优先采用病因治疗和症状导向的方法。
