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儿科谵妄的更新及临床意义。

Updates and Clinical Implications of Pediatric Delirium.

机构信息

Yale University School of Nursing, Orange, CT, USA; Yale New Haven Hospital, Pediatric Critical Care, New Haven, CT, USA.

University of Florida College of Nursing, 1225 Center Drive, PO Box 100197, Gainesville, FL 32610, USA.

出版信息

Crit Care Nurs Clin North Am. 2023 Sep;35(3):315-325. doi: 10.1016/j.cnc.2023.04.006. Epub 2023 Jun 4.

Abstract

Delirium is a fluctuating level of awareness based on a physiologic disease process. Within pediatrics, delirium affects approximately 30% of patients admitted to critical care units and is associated with increased mortality, morbidity, length of stay, and care costs. Multiple pediatric critical care societies recommend the implementation of screening practices using validated delirium tools. Delirium remains underrecognized because of suboptimal screening and protocol implementation in pediatric critical care units nationally and internationally. The mainstay of delirium prevention and management is nonpharmacologic, focusing on normalizing a patient's environment, sleep/wake cycles, nutritional status, and activity levels.

摘要

谵妄是一种基于生理疾病过程的意识波动状态。在儿科领域,约 30%的入住重症监护病房的患儿会发生谵妄,并且与死亡率、发病率、住院时间和医疗费用的增加相关。多个儿科重症监护学会建议使用经过验证的谵妄工具实施筛查实践。由于在全国和国际的儿科重症监护病房中,筛查和方案实施情况欠佳,导致谵妄的识别率仍然较低。谵妄的预防和管理的主要方法是非药物治疗,重点是使患者的环境、睡眠/觉醒周期、营养状况和活动水平正常化。

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