Rengel Kimberly F, Wahl Lindsay A, Sharma Archit, Lee Howard, Hayhurst Christina J
Division of Anesthesiology Critical Care Medicine, Department of Anesthesiology, Vanderbilt University Medical Center, 1211 21st Avenue South, 422 MAB, Nashville, TN 37212, USA.
Department of Anesthesiology, Northwestern University Feinberg School of Medicine, Northwestern Memorial Hospital, 251 East Huron, Suite 5-704, Chicago, IL 60611, USA.
Anesthesiol Clin. 2023 Mar;41(1):175-189. doi: 10.1016/j.anclin.2022.10.011.
Delirium, an acute, fluctuating impairment in cognition and awareness, is one of the most common causes of postoperative brain dysfunction. It is associated with increased hospital length of stay, health care costs, and mortality. There is no FDA-approved treatment of delirium, and management relies on symptomatic control. Several preventative techniques have been proposed, including the choice of anesthetic agent, preoperative testing, and intraoperative monitoring. Frailty, a state of increased vulnerability to adverse events, is an independent and potentially modifiable risk factor for the development of delirium. Diligent preoperative screening techniques and implementation of prevention strategies could help improve outcomes in high-risk patients.
谵妄是一种急性、波动性的认知和意识障碍，是术后脑功能障碍最常见的原因之一。它与住院时间延长、医疗费用增加和死亡率升高有关。目前尚无美国食品药品监督管理局（FDA）批准的谵妄治疗方法，治疗主要依靠症状控制。已经提出了几种预防技术，包括麻醉剂的选择、术前检查和术中监测。虚弱是一种对不良事件易感性增加的状态，是谵妄发生的独立且可能可改变的危险因素。认真的术前筛查技术和预防策略的实施有助于改善高危患者的预后。
