心脏手术中谵妄的危险因素及预防

M. Preveden, Andrej Preveden, Ranko Zdravković, Nina Dračina, Vladislava Djoric, M. Tatic
{"title":"心脏手术中谵妄的危险因素及预防","authors":"M. Preveden, Andrej Preveden, Ranko Zdravković, Nina Dračina, Vladislava Djoric, M. Tatic","doi":"10.2298/mpns2204133p","DOIUrl":null,"url":null,"abstract":"Introduction. Delirium is defined as an acute change in mental status that leads to disturbance in perception, thinking, memory, attention, emotional status, as well as sleep rhythm disorders and is most often reversible. Postoperative delirium is an acute mental disorder that develops after cardiovascular surgery with an incidence of 20 - 50% of operated patients. This complication is associated with a longer hospitalization, longer stay in the intensive care unit, as well as increased morbidity and mortality. Risk Factors. The risk factors are divided into preoperative, intraoperative and postoperative. The most common preoperative risk factors are older age, stenosis of the carotid arteries, previous cerebral diseases, depression, diabetes, hypertension, low ejection fraction of the left ventricle, as well as heart rhythm disorders. Intraoperative risk factors include the type of surgery, type of anesthesia, duration of extracorporeal circulation, and duration of aortic clamp. The most important postoperative risk factors include the use of psychoactive drugs, prolonged pain, the use of opioid drugs, duration of mechanical ventilation, and the length of stay in the intensive care unit. Prevention. Prevention is a very important aspect that is most often focused on intraoperative and postoperative precipitating factors. Preventive treatment includes pharmacological and non-pharmacological methods. The main recommendation refers to avoiding routine use of antipsychotics. Conclusion. Continuous infusion of dexmedetomidine compared to propofol reduces the incidence of postoperative delirium. Nonpharmacological approach consists of a series of procedures that are carried out postoperatively, such as the protocol that includes monitoring of Awakening, Breathing, Coordination, Delirium, Early mobility, and Family engagement.","PeriodicalId":87940,"journal":{"name":"Calcutta medical review","volume":"458 1","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":"{\"title\":\"Delirium in cardiac surgery - risk factors and prevention\",\"authors\":\"M. Preveden, Andrej Preveden, Ranko Zdravković, Nina Dračina, Vladislava Djoric, M. Tatic\",\"doi\":\"10.2298/mpns2204133p\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Introduction. Delirium is defined as an acute change in mental status that leads to disturbance in perception, thinking, memory, attention, emotional status, as well as sleep rhythm disorders and is most often reversible. Postoperative delirium is an acute mental disorder that develops after cardiovascular surgery with an incidence of 20 - 50% of operated patients. This complication is associated with a longer hospitalization, longer stay in the intensive care unit, as well as increased morbidity and mortality. Risk Factors. The risk factors are divided into preoperative, intraoperative and postoperative. The most common preoperative risk factors are older age, stenosis of the carotid arteries, previous cerebral diseases, depression, diabetes, hypertension, low ejection fraction of the left ventricle, as well as heart rhythm disorders. Intraoperative risk factors include the type of surgery, type of anesthesia, duration of extracorporeal circulation, and duration of aortic clamp. The most important postoperative risk factors include the use of psychoactive drugs, prolonged pain, the use of opioid drugs, duration of mechanical ventilation, and the length of stay in the intensive care unit. Prevention. Prevention is a very important aspect that is most often focused on intraoperative and postoperative precipitating factors. Preventive treatment includes pharmacological and non-pharmacological methods. The main recommendation refers to avoiding routine use of antipsychotics. Conclusion. Continuous infusion of dexmedetomidine compared to propofol reduces the incidence of postoperative delirium. Nonpharmacological approach consists of a series of procedures that are carried out postoperatively, such as the protocol that includes monitoring of Awakening, Breathing, Coordination, Delirium, Early mobility, and Family engagement.\",\"PeriodicalId\":87940,\"journal\":{\"name\":\"Calcutta medical review\",\"volume\":\"458 1\",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2022-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Calcutta medical review\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.2298/mpns2204133p\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Calcutta medical review","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.2298/mpns2204133p","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 1

摘要

介绍。谵妄被定义为精神状态的急性变化,导致感知、思维、记忆、注意力、情绪状态和睡眠节奏紊乱,并且通常是可逆的。术后谵妄是心血管手术后发生的急性精神障碍,发生率为20 - 50%。这种并发症与住院时间较长、在重症监护病房待的时间较长以及发病率和死亡率增加有关。风险因素。危险因素分为术前、术中、术后。最常见的术前危险因素是年龄较大、颈动脉狭窄、既往脑疾病、抑郁症、糖尿病、高血压、左心室射血分数低以及心律失常。术中危险因素包括手术类型、麻醉类型、体外循环持续时间和主动脉夹钳持续时间。术后最重要的危险因素包括精神活性药物的使用、持续的疼痛、阿片类药物的使用、机械通气的持续时间以及在重症监护病房的住院时间。预防。预防是一个非常重要的方面,最常关注的是术中和术后的诱发因素。预防性治疗包括药理学和非药理学方法。主要建议是避免常规使用抗精神病药物。结论。与异丙酚相比,持续输注右美托咪定可降低术后谵妄的发生率。非药物治疗包括一系列术后实施的程序,如包括觉醒、呼吸、协调、谵妄、早期活动和家庭参与监测的方案。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
Delirium in cardiac surgery - risk factors and prevention
Introduction. Delirium is defined as an acute change in mental status that leads to disturbance in perception, thinking, memory, attention, emotional status, as well as sleep rhythm disorders and is most often reversible. Postoperative delirium is an acute mental disorder that develops after cardiovascular surgery with an incidence of 20 - 50% of operated patients. This complication is associated with a longer hospitalization, longer stay in the intensive care unit, as well as increased morbidity and mortality. Risk Factors. The risk factors are divided into preoperative, intraoperative and postoperative. The most common preoperative risk factors are older age, stenosis of the carotid arteries, previous cerebral diseases, depression, diabetes, hypertension, low ejection fraction of the left ventricle, as well as heart rhythm disorders. Intraoperative risk factors include the type of surgery, type of anesthesia, duration of extracorporeal circulation, and duration of aortic clamp. The most important postoperative risk factors include the use of psychoactive drugs, prolonged pain, the use of opioid drugs, duration of mechanical ventilation, and the length of stay in the intensive care unit. Prevention. Prevention is a very important aspect that is most often focused on intraoperative and postoperative precipitating factors. Preventive treatment includes pharmacological and non-pharmacological methods. The main recommendation refers to avoiding routine use of antipsychotics. Conclusion. Continuous infusion of dexmedetomidine compared to propofol reduces the incidence of postoperative delirium. Nonpharmacological approach consists of a series of procedures that are carried out postoperatively, such as the protocol that includes monitoring of Awakening, Breathing, Coordination, Delirium, Early mobility, and Family engagement.
求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
自引率
0.00%
发文量
0
期刊最新文献
Drug development accelerated by artificial intelligence The artificial intelligence pharma era after “Chat Generative Pre-trained Transformer” Artificial Intelligence-enabled contactless sensing for medical diagnosis Cold-chain transmission, asymptomatic infection, mass screening, vaccine, and modelling: what we know so far for coronavirus disease 2019 control and experience in China A review on COVID-19 transmission, epidemiological features, prevention and vaccination
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1