Adams Samuel J, Sprecher Alicia
Neurology - Child Neurology, Medical College of Wisconsin, Children's Wisconsin, 8915 W. Connell Cţ Milwaukee, WI 53226, USA.
Pediatrics - Neonatology, Medical College of Wisconsin, Children's Wisconsin, 8915 W. Connell Ct, Milwaukee, WI 53226, USA.
Clin Perinatol. 2022 Mar;49(1):1-14. doi: 10.1016/j.clp.2021.11.001. Epub 2022 Jan 21.
Delirium is likely present in the neonatal intensive care unit and has been largely unrecognized. There are several risk factors for delirium including illness severity, neurosedative exposure, and environmental disruptions that put infants at risk for delirium. Regular use of scoring systems should be considered to improve delirium detection. When identified, initial steps in management should include resolving underlying causes and implementation of standard nonpharmacologic measures. Mounting pediatric evidence suggests that the atypical antipsychotics, as well as the α-2 agonists, may be additionally beneficial in treating delirium as well as improving the ability to wean off other neurosedative medications.
新生儿重症监护病房中很可能存在谵妄，但在很大程度上未被识别。谵妄有多种风险因素，包括疾病严重程度、神经镇静药物暴露以及环境干扰，这些因素使婴儿有患谵妄的风险。应考虑定期使用评分系统以改善谵妄的检测。一旦确诊，初始管理步骤应包括消除潜在病因并实施标准的非药物措施。越来越多的儿科证据表明，非典型抗精神病药物以及α-2激动剂可能在治疗谵妄以及提高停用其他神经镇静药物的能力方面具有额外益处。
