Malas Nasuh, Brahmbhatt Khyati, McDermott Cristin, Smith Allanceson, Ortiz-Aguayo Roberto, Turkel Susan
Department of Psychiatry and Pediatrics, University of Michigan Medical School, 1500 East Medical Center Drive, L5023, SPC 5277, Ann Arbor, MI, 48109, USA.
Department of Psychiatry, University of California San Francisco Benioff Children's Hospital, San Francisco, CA, USA.
Curr Psychiatry Rep. 2017 Aug 12;19(9):65. doi: 10.1007/s11920-017-0817-3.
Delirium describes a syndrome of acute brain dysfunction with severe consequences on patient outcomes, medical cost, morbidity, and mortality. It represents a final common pathway of numerous pathophysiologic disturbances disrupting cerebral homeostasis. The diagnosis is predicated on recognition of the clinical features of the syndrome through ongoing clinical assessment. Early identification can be aided by routine screening, particularly in high-risk populations. Evaluation and management are continuous and simultaneous processes involving a multidisciplinary care team including child psychiatry consultation. Prevention, early identification and management are critical in alleviating symptoms, improving outcomes, and reducing distress for patients, families, and care teams. This review highlights our current understanding regarding pediatric delirium, its mechanisms, clinical manifestations, detection and management.
谵妄是一种急性脑功能障碍综合征，对患者的预后、医疗费用、发病率和死亡率都有严重影响。它是众多破坏脑内稳态的病理生理紊乱的最终共同途径。诊断基于通过持续的临床评估识别该综合征的临床特征。常规筛查有助于早期识别，尤其是在高危人群中。评估和管理是持续且同步的过程，需要多学科护理团队参与，包括儿童精神科会诊。预防、早期识别和管理对于减轻症状、改善预后以及减少患者、家庭和护理团队的痛苦至关重要。本综述重点介绍了我们目前对小儿谵妄的认识、其机制、临床表现、检测和管理。
