Pessoa Renata Fittipaldi, Nácul Flávio Eduardo
Núcleo de Pesquisa Clínica da Clínica São Vicente, Rio de Janeiro, RJ.
Centro de Terapia Intensiva, Núcleo de Pesquisa Clínica da Clínica São Vicente, Rio de Janeiro, RJ.
Rev Bras Ter Intensiva. 2006 Jun;18(2):190-5.
Delirium is a frequent finding in the critically ill patient. Although it is associated with increased morbidity and mortality, it is often not recognized by intensive care doctors. This review will address the main issues regarding delirium in critically ill patients.
Definition, incidence, mortality, risk factors, diagnosis, and treatment of delirium in the critically ill.
Deliriumis defined as a disturbance of consciousness, attention, cognition and perception that occurs frequently in critically ill patients. It occurs in as many as 80% of mechanically ventilated ICU patients. Risk factors for delirium include acute systemic illnesses, older age, pre-existing cognitive impairment, sleep deprivation, and medications with anticholinergic activity. Although new assessment tools are available for rapidly and accurately measuring deliriumin critically ill patients, healthcare professionals still do not regularly monitor for this condition. In recent years, the emphasis in the approach to delirium has shifted to systematic screening and prevention. Haloperidol remains the standard treatment for delirium, but there is some evidence for the efficacy of risperidone.
谵妄在重症患者中很常见。尽管它与发病率和死亡率的增加相关，但重症监护医生常常未能识别。本综述将阐述重症患者谵妄的主要问题。
重症患者谵妄的定义、发病率、死亡率、危险因素、诊断及治疗。
谵妄被定义为意识、注意力、认知和感知的紊乱，在重症患者中频繁发生。在多达80%的机械通气重症监护病房患者中会出现。谵妄的危险因素包括急性全身性疾病、老年、既往存在的认知障碍、睡眠剥夺以及具有抗胆碱能活性的药物。尽管有新的评估工具可用于快速准确地测量重症患者的谵妄，但医疗保健专业人员仍未定期监测这种情况。近年来，对谵妄的处理重点已转向系统筛查和预防。氟哌啶醇仍然是谵妄的标准治疗药物，但有一些证据表明利培酮也有效。
