重症监护病房谵妄与重症监护病房相关创伤后应激障碍
Intensive Care Unit Delirium and Intensive Care Unit-Related Posttraumatic Stress Disorder.
作者信息
Marra Annachiara, Pandharipande Pratik P, Patel Mayur B
机构信息
Division of Allergy, Pulmonary and Critical Care Medicine, Center for Health Services Research, University of Naples Federico II, Vanderbilt University Medical Center, 1215 21st Avenue South, Medical Center East, Suite 6100, Nashville, TN 37232-8300, USA.
Division of Anesthesiology Critical Care Medicine, Department of Anesthesiology, Center for Health Services Research, Vanderbilt University Medical Center, 1211 21st Avenue South, Medical Arts Building, Suite 526, Nashville, TN 37212, USA.
出版信息
Surg Clin North Am. 2017 Dec;97(6):1215-1235. doi: 10.1016/j.suc.2017.07.008. Epub 2017 Oct 5.
Abstract
Delirium is one of the most common behavioral manifestations of acute brain dysfunction in the intensive care unit (ICU) and is a strong predictor of worse outcome. Routine monitoring for delirium is recommended for all ICU patients using validated tools. In delirious patients, a search for all reversible precipitants is the first line of action and pharmacologic treatment should be considered when all causes have been ruled out, and it is not contraindicated. Long-term morbidity has significant consequences for survivors of critical illness and for their caregivers. ICU patients may develop posttraumatic stress disorder related to their critical illness experience.
摘要
谵妄是重症监护病房（ICU）急性脑功能障碍最常见的行为表现之一，也是预后较差的有力预测指标。建议使用经过验证的工具对所有ICU患者进行谵妄常规监测。对于谵妄患者，首先要排查所有可逆性诱因，当所有病因均被排除且无用药禁忌时，应考虑药物治疗。长期发病对危重症幸存者及其照顾者会产生重大影响。ICU患者可能会因危重症经历而患上创伤后应激障碍。
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