Sadlonova Monika, von Arnim Christine A F
Klinik für Psychosomatische Medizin und Psychotherapie, Herzzentrum, Universitätsmedizin Göttingen, Göttingen, Deutschland.
Klinik für Herz‑, Thorax und Gefäßchirurgie, Herzzentrum, Universitätsmedizin Göttingen, Göttingen, Deutschland.
Inn Med (Heidelb). 2023 Sep;64(9):855-863. doi: 10.1007/s00108-023-01561-7. Epub 2023 Aug 4.
Delirium is an acute confusional state with typically fluctuating disturbances of attention, cognition, and qualitative awareness. Its incidence depends on the patient group. In the development of delirium, predisposing factors such as age, frailty, multimorbidity, surgical interventions, and pre-existing dementia are of high clinical relevance. The diagnosis of delirium should be based on symptoms and validated screening methods (e.g., Confusion Assessment Method). As delirium is a direct physiological consequence of a medical condition, the potential underlying cause(s) should be diagnosed. Prevention and therapy are primarily multimodal, non-pharmacological treatments such as reorientation, early mobilization, and sleep improvement. If symptomatic pharmacological treatment is necessary (e.g., due to delirium-related agitation), careful drug selection should be made depending on the patient population and symptoms.
谵妄是一种急性意识模糊状态，通常伴有注意力、认知和质性意识的波动紊乱。其发病率取决于患者群体。在谵妄的发生过程中，年龄、虚弱、多种疾病并存、手术干预和既往痴呆等易感因素具有高度临床相关性。谵妄的诊断应基于症状和经过验证的筛查方法（如谵妄评估方法）。由于谵妄是一种疾病的直接生理后果，应诊断潜在的病因。预防和治疗主要是多模式的非药物治疗，如重新定向、早期活动和改善睡眠。如果需要进行症状性药物治疗（如由于与谵妄相关的激越），应根据患者群体和症状谨慎选择药物。
