Institute of Health Sciences, College of Medical Sciences of the University of Rzeszow, Poland St. Warzywna1A, 35-310 Rzeszow, Poland.
Department of Anesthesiology and Intensive Medicine, University Hospital Centre Zagreb, University of Applied Health Sciences, Mlinarska cesta 38, 10000 Zagreb, Croatia.
Int J Environ Res Public Health. 2021 Apr 12;18(8):4029. doi: 10.3390/ijerph18084029.
The problem of delirium during extracorporeal membrane oxygenation (ECMO) therapy, which has rarely been studied, is an important issue since it is necessary to ensure patient safety during therapy. This study aimed to show the incidence of delirium in patients after extracorporeal membrane oxygenation therapy and factors affecting the occurrence of delirium in this group of patients.
A cross-sectional study was conducted.
The study involved a group of patients from an intensive cardiac care unit who received extracorporeal membrane oxygenation therapy. The study lasted for more than two years, in the period from 2018 until 2020. The Nursing Delirium Screening Scale (NuDESC) and the Delirium Observation Screening Scale (DOSS) were applied. Additionally, the patients were examined using Numeric Rating Scale (NRS), the Insomnia Severity Index (ISI), the Richmond Agitation Sedation Scale (RASS), the Ramsay Sedation Scale (RSS), and a thirst intensity scale; ultimately, relationships between these factors and delirium were examined.
In patients who underwent ExtraCorporeal Membrane Oxygenation (ECMO) therapy, delirium was confirmed by the NuDESC in 68.75% of patients in the evening hours, while it was measured by the DOSS scale in 84.38% of patients in the morning. The study found that ECMO delirium was not associated with hyperactivity, sleep disturbance, sedation, pain, or thirst.
Delirium in patients undergoing ECMO therapy was confirmed by both the NuDESC and DOSS. Factors such as thirst and sleep disturbance after ECMO therapy were shown to influence the occurrence of delirium. The diagnosis of delirium using standardized scales is possible provided that more tests are carried out. Research should be conducted to determine whether the NuDESC is equivalent to the DOSS.
体外膜肺氧合（ECMO）治疗期间发生谵妄的问题很少被研究，这是一个重要的问题，因为在治疗过程中必须确保患者的安全。本研究旨在展示 ECMO 治疗后患者发生谵妄的发生率，以及影响该组患者发生谵妄的因素。
一项横断面研究。
研究对象来自重症心脏监护病房接受 ECMO 治疗的患者。研究持续了两年多，时间为 2018 年至 2020 年。应用了护理谵妄筛查量表（NuDESC）和谵妄观察筛查量表（DOSS）。此外，还使用数字评分量表（NRS）、失眠严重程度指数（ISI）、Richmond 躁动镇静量表（RASS）、Ramsay 镇静量表（RSS）和口渴强度量表对患者进行了检查；最终，检查了这些因素与谵妄之间的关系。
在接受体外膜肺氧合（ECMO）治疗的患者中，NuDESC 在晚上 68.75%的患者中证实存在谵妄，而 DOSS 量表在早上 84.38%的患者中测量到谵妄。研究发现，ECMO 谵妄与活动过度、睡眠障碍、镇静、疼痛或口渴无关。
通过 NuDESC 和 DOSS 都证实了接受 ECMO 治疗的患者存在谵妄。ECMO 治疗后口渴和睡眠障碍等因素表明会影响谵妄的发生。通过使用标准化量表进行谵妄诊断是可能的，前提是进行更多的测试。应开展研究，以确定 NuDESC 是否等同于 DOSS。
