Division of Critical Care Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA.
Division of Pulmonary and Critical Care Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA.
J Intensive Care Med. 2019 Mar;34(3):183-190. doi: 10.1177/0885066618771528. Epub 2018 Apr 26.
Delirium is a multifactorial entity, and its understanding continues to evolve. Delirium has been associated with increased morbidity, mortality, length of stay, and cost for hospitalized patients, especially for patients in the intensive care unit (ICU). Recent literature on delirium focuses on specific pharmacologic risk factors and pharmacologic interventions to minimize course and severity of delirium. While medication management clearly plays a role in delirium management, there are a variety of nonpharmacologic interventions, pharmacologic minimization strategies, and protocols that have been recently described. A PubMed search was performed to review the evidence for nonpharmacologic management, pharmacologic minimization strategies, and prevention of delirium for patients in the ICU. Recent approaches were condensed into 10 actionable steps to manage delirium and minimize medications for ICU patients and are presented in this review.
谵妄是一种多因素的实体，其认识仍在不断发展。谵妄与住院患者（尤其是重症监护病房 (ICU) 患者）的发病率、死亡率、住院时间和费用增加有关。最近关于谵妄的文献主要集中在特定的药物危险因素和药物干预措施上，以尽量减少谵妄的发生和严重程度。虽然药物管理显然在谵妄管理中起着重要作用，但还有各种非药物干预措施、药物最小化策略和最近描述的方案。进行了一项 PubMed 搜索，以审查 ICU 患者非药物管理、药物最小化策略和预防谵妄的证据。最近的方法被浓缩为 10 个可操作的步骤，以管理 ICU 患者的谵妄并尽量减少药物治疗，并在本综述中介绍。
