POSTOPERATIVE DELIRIUM: MODERN ASPECTS OF DIAGNOSIS, PREVENTION AND THERAPY
https://doi.org/10.25207/1608-6228-2018-25-6-184-191
Abstract
Delirium is an acute change in mental status in the form of disorientation in time and space, loss of attention and disruption of sleep/wake patterns. From the psychopathological point of view, delirium is a qualitative disorder of consciousness with concomitant disorders of perception (illusions and hallucinations). Postoperative delirium (POD) is one of the postoperative complications that occur in patients of any age, including children. As a rule, POD develops within 5-7 days after the surgery. The frequency of its occurrence varies in different age groups. Nowadays more than 230 million surgeries are performed annually in the world, and the frequency of POD depends on the type of surgical operations, age of a patient and a number of risk factors. The effects of POD include cognitive disorders, prolonged hospitalization, increased mortality, leading to a significant increase in healthcare costs. The implementation of the protocol on the diagnosis and therapy of delirium, based on modern recommendations, can improve the clinical outcome.
About the Authors
M. M. Sokolova
Federal State Budgetary Educational Institution of Higher Education Northern State Medical University of the Ministry of Healthcare of the Russian Federation.
Russian Federation
Russian Federation
Troicki prospekt 51, Arkhangelsk, Russia, 163000.
M. Y. Kirov
Federal State Budgetary Educational Institution of Higher Education Northern State Medical University of the Ministry of Healthcare of the Russian Federation.
Russian Federation
Troicki prospekt 51, Arkhangelsk, Russia, 163000.
Russian Federation
Troicki prospekt 51, Arkhangelsk, Russia, 163000.
K. V. Shelygin
Federal State Budgetary Educational Institution of Higher Education Northern State Medical University of the Ministry of Healthcare of the Russian Federation.
Russian Federation
Troicki prospekt 51, Arkhangelsk, Russia, 163000.
Russian Federation
Troicki prospekt 51, Arkhangelsk, Russia, 163000.
References
1. Weiss B., Spies C.D. et all. European Society of Anaesthesi-ology evidence-based and consensus-based guideline on postop-erative delirium. Eur. J. Anaesthesiol. 2017; 34: 192-214.
2. Likhvantsev V.V., Ulitkina O.N., Rezepov N.A. Postoperative delirium: what new does novel guidelines by ESA- 2017 offer? Messenger of anesthesiology and resuscitation. 2017; 14(2): 41-47. (In Russ., English abstract).
3. Ostrye psihoticheskie rasstrojstva v intensivnoj terapii: Prakticheskoe rukovodstvo dlya anesteziologov-reani- matologov, hirurgov, nevrologov i psihiatrov. Pod red. akad. RAN prof. B.R.Gel'fanda i prof. V.N.Krasnova. M.: OOO «Izdatel'stvo «Medicinskoe informacionnoe agentstvo», 2014. 232 s. (In Russ.).
4. Federal'nye klinicheskie rekomendacii po diagnostike i lecheniyu abstinentnogo sostoyaniya s deliriem, vyzvannogo upotrebleniem psihoaktivnyh veshchestv Rossijskoe obshchestvo psihiatrov. 2014 g. (In Russ.).
5. Jaspers К. Allgemeine. Psychopathologie. Berlin. 1929.
6. Peitz G.J., Balas M.C., Olsen K.M., Pun B.T., Ely E.W. Top 10 myths regarding sedation and delirium in the ICU. Crit. Care Med. 2013; 41: 46-56.
7. Reade M.C., Finfer S. Sedation and delirium in the intensive care unit. N. Engl. J. Med. 2014; 370: 454.
8. Nilsson M, Sonne C. Diagnostics and treatment of Wernicke-Korsakoff syndrome patients with an alcohol abuse. Ugeskr Laeger. 2013; 175 (14): 942-944.
9. Sivolap Y.P., Damulin I.V. Wernicke-Korsakoff syndrome. Neurology, Neuropsychiatry, Psychosomatics. 2014; 6 (4): 76-80. (In Russ., English abstract)].
10. Semple D., Smyth R. Oxford Handbook of Psychiatry Ox-ford: Oxford University Press. 2013: 1057.
11. Ahmed S., Murugan R. Dexmedetomidine use in the ICU: are we there yet? Crit. Care. 2013; 17: 320.
12. Latronico N. Haloperidol and delirium in the ICU: the fin¬ger pointing to the moon. Intensive Care Med. 2018 Jun 23 [Epub ahead of print].
13. Treatment of alcohol withdrawal delirium. WHO, 2012. http://urlid.ru/bbew
14. Nguyen J., Nacpil N. Effectiveness of dexmedetomidine versus propofol on extubation times, length of stay and mortality rates in adult cardiac surgery patients: a systematic review and meta-analysis. JBI Database System Rev. Implement Rep. 2018; 16(5): 1220-1239.
15. Marcantonio E.R. Marcantonio E.R. Delirium in hospital¬ized older adults. N. Engl. J. Med. 2017; 377: 1456-1466.
16. Barnes-Daly M.A., Phillips G., Ely E.W. Improving hospital survival and reducing brain dysfunction at seven California community hospitals: implementing PAD guidelines via the ABCDEF bundle in 6,064 Patients. Crit. Care. Med. 2017; 45: 171¬178.
17. Kang J., Lee M., Ko H. et all. Effect of nonpharmacologi¬cal interventions for the prevention of delirium in the intensive care unit: A systematic review and meta-analysis. J. Crit. Care. 2018; 48: 372-384.
18. Zoremba N., Coburn M., Schalte G. Delirium in intensive care patients: A multiprofessional challenge. Anaesthesist. 2018; Oct 8. [Epub ahead of print].
19. Thomson A.D. Guerrini I., Marshall E.J. The evolution and treatment of Korsakoff's syndrome: out of sight, out of mind? Neu- ropsychol. rev. 2012; 22: 81-92.
20. Flukiger J., Hollinger A., Speich B. et. all. Dexmedetomi¬dine in prevention and treatment of postoperative and intensive care unit delirium: a systematic review and meta-analysis. Ann. Intensive Care. 2018; 8(1): 92.
21. Ng K.T., Shubash C.J., Chong J.S. The effect of dexme- detomidine on delirium and agitation in patients in intensive care: systematic review and meta-analysis with trial sequential analysis. Anaesthesia. 2018 Oct . [Epub ahead of print].
Review
For citations:
Sokolova M.M., Kirov M.Y., Shelygin K.V. POSTOPERATIVE DELIRIUM: MODERN ASPECTS OF DIAGNOSIS, PREVENTION AND THERAPY. Kuban Scientific Medical Bulletin. 2018;25(6):184-191. (In Russ.) https://doi.org/10.25207/1608-6228-2018-25-6-184-191
Views:
4074
Email this article 