Hermes C, Ottens T, Knitter P, Hauss O, Bellgardt M, von Dossow V
, Friedrich-Ebert-Straße 60, 53177, Bonn, Deutschland.
Klinik für Interdisziplinäre Intensivmedizin, Haga Ziekenhuis, Den Haag, Niederlande.
Med Klin Intensivmed Notfmed. 2022 Sep;117(6):479-488. doi: 10.1007/s00063-022-00943-3. Epub 2022 Jul 29.
Postoperative delirium is a challenge for patients, relatives, nurses, physicians, and healthcare systems. Delirium is associated with increased mortality, longer hospitalization, reduced quality of life, and higher average treatment costs. Consequently, the most recent version of the German Guideline on Analgesia, Sedation and Delirium Management in Intensive Care Medicine (DAS Guideline 2020) emphasizes the importance of delirium prevention. In particular, nonpharmacological interventions play a special role in this regard for basically all patients receiving intensive care. The DAS Guideline stresses the importance of regular systematic screening with validated instruments to recognize developing delirium early and take the appropriate measures in time, as the duration of delirious conditions influences both mortality and quality of life. If delirium manifests, intervention must be immediate and symptom-oriented.
术后谵妄对患者、家属、护士、医生及医疗系统来说都是一项挑战。谵妄与死亡率增加、住院时间延长、生活质量下降以及平均治疗成本升高相关。因此，最新版的德国重症医学镇痛、镇静与谵妄管理指南（《2020年DAS指南》）强调了预防谵妄的重要性。特别是，非药物干预在这方面对基本上所有接受重症监护的患者都起着特殊作用。《DAS指南》强调了使用经过验证的工具进行定期系统筛查的重要性，以便早期识别正在发生的谵妄并及时采取适当措施，因为谵妄状态的持续时间会影响死亡率和生活质量。如果出现谵妄，必须立即进行以症状为导向的干预。
