Plácido Daniela Carvalho, Pinto Maria do Rosário, Durão Maria Cândida, Henriques Helga Rafael, Teixeira Joana Ferreira
Student in Master in Medical-Surgical Nursing - Critical Care, RN in Unidade de Urgência Médica da ULS S. José, Lisbon, Portugal.
Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR) - Escola Superior de Enfermagem de Lisboa - id. Care Project, Lisbon, Portugal.
Acute Crit Care. 2025 Aug;40(3):373-392. doi: 10.4266/acc.005221. Epub 2025 Aug 29.
Delirium is an acute disorder characterized by changes in the patient's cognitive function, which another neurocognitive or pre-existing disease cannot explain. It produces adverse outcomes for critically ill patients and their families related to adverse events associated with the accidental removal of medical devices that increase the risk of the patient and the length of stay at the hospital, manifested by agitation and confusion behaviors. Five reviewers conducted An Umbrella Review from May to August 2023 through research in the databases Medline, CINAHL, Scopus, Web of Science, Cochrane Database of Systematic Reviews and articles obtained through research in other sources. After verifying their eligibility, we obtained 22 systematic reviews and meta-analyses for data extraction and analysis. From the results obtained, the importance of the implementation of surveillance interventions and systematic evaluation of the presence of delirium is highlighted, with particular emphasis on the use of the scale, Confusion Assessment Method, followed by the implementation of multicomponent interventions, pharmacological or not, highlighting the use of dexmedetomidine and family as support, as well early mobilization for the management of delirium. Managing delirium in critically ill patients based on Meyer and Lavin's theory, is an area sensitive to nursing care with an impact on the prevention of complications and consequent promotion of the safety of these patients, which also translates into positive results for the family and health organizations, reducing morbidity, mortality, length of stay and health costs.
谵妄是一种急性疾病，其特征为患者认知功能发生改变，且无法用其他神经认知疾病或既往存在的疾病来解释。它会给重症患者及其家属带来不良后果，这些后果与医疗设备意外移除相关的不良事件有关，会增加患者风险及住院时间，表现为激动和混乱行为。2023年5月至8月，五名评审员通过检索Medline、CINAHL、Scopus、Web of Science、Cochrane系统评价数据库以及通过其他来源检索获得的文章进行了一项伞状综述。在核实其纳入资格后，我们获得了22项系统评价和荟萃分析以进行数据提取和分析。从获得的结果来看，强调了实施监测干预措施以及对谵妄存在情况进行系统评估的重要性，尤其强调使用谵妄评估方法量表，随后实施多组分干预措施，无论是否为药物干预，突出右美托咪定的使用以及家属支持，还有早期活动对谵妄的管理作用。基于迈耶和拉文的理论，对重症患者的谵妄进行管理是一个对护理敏感的领域，对预防并发症以及促进这些患者的安全有影响，这也会给患者家属和卫生组织带来积极结果，降低发病率、死亡率、住院时间和医疗成本。
