Ahlers Eike
Johanniter-Krankenhaus Treuenbrietzen, Johanniter-Straße 1, 14929, Treuenbrietzen, Deutschland.
Klinik für Psychiatrie und Psychotherapie, Charité Universitätsmedizin Berlin, Berlin, Deutschland.
Nervenarzt. 2025 Jul;96(4):342-347. doi: 10.1007/s00115-025-01836-4. Epub 2025 May 30.
Inquiries about delirium are a very common request in psychiatric consultation and liaison services (CL).
What practical procedures can be derived from current recommendations?
Evaluation of current guidelines and literature recommendations, as well as of the experiences in interdisciplinary planning of delirium management at various hospitals and of comments of participants in the author's workshops.
Delirium is seen as a major burden in the treatment of seriously ill patients across all medical disciplines. There are national and international medical guideline recommendations that unanimously recommend institutional delirium management, which follows a standardized approach for the respective department to minimize risk and prevent delirium. Cognitive deficits can follow delirium, especially in old age. Pathophysiological models can support the indication for treatment. Nonpharmacological techniques are effective; pharmacological steps should be carefully considered. Communication with those affected and their relatives and the transition upon discharge or transfer should be explicitly included.
The CL can support steps and department-specific optimization of multiprofessional and delirium management, especially differential psychopharmacotherapy. Further efforts in the implementation of effective delirium management are also possible institutionally in order to improve the prognosis and quality of life of those affected.
在精神科会诊-联络服务(CL)中,关于谵妄的咨询是非常常见的需求。
从当前建议中可以得出哪些实用程序?
评估当前指南和文献建议,以及各医院谵妄管理跨学科规划的经验和作者研讨班参与者的意见。
谵妄被视为所有医学学科中重症患者治疗的主要负担。有国家和国际医学指南建议一致推荐机构性谵妄管理,各科室应遵循标准化方法以尽量降低风险并预防谵妄。谵妄后可能出现认知缺陷,尤其是在老年患者中。病理生理模型可支持治疗指征。非药物技术有效;药物治疗步骤应谨慎考虑。应明确包括与患者及其亲属的沟通以及出院或转院时的过渡。
CL可支持多专业和谵妄管理的步骤及科室特定优化,尤其是差异心理药物治疗。为改善患者预后和生活质量,各机构在实施有效的谵妄管理方面也可进一步努力。