ICU谵妄和ABCDE集束化预防方案
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a) prevalent (if it is detected at the time of admission);
b) incident (if it emerges during the hospital length of stay);
and c) persistent (if the symptoms persist over time)
谵妄以急性器官功能障碍为表现形式：倾向于1天 内波动性的、迅速发展的意识和认知紊乱。
谵妄的主要特征
The American Psychiatric Association (APA)Diagnostic and Statistical Manual of Mental Disorders,fourth edition, text revision (DSM-IV) defines 4 key features of delirium:
谵妄在ICU很常见 60-80%机械通气患者发生谵妄 20-50%非机械通气患者发生谵妄
内容
谵妄的流行病学 谵妄概念、主要特征和分类 谵妄的目前关注情况 谵妄的危害 谵妄的风险因素 谵妄评估及诊断 谵妄的预防 谵妄预防的集束化方案--ABCDE方案 谵妄治疗
Delirium
-谵妄
南华大学附属第一医院ICU 王桥生
内容
谵妄的流行病学 谵妄概念、主要特征和分类 谵妄的目前关注情况 谵妄的危害 谵妄的风险因素 谵妄评估及诊断 谵妄的预防 谵妄预防的集束化方案--ABCDE方案 谵妄治疗
Biblioteka Baidu
流行病学
Delirium occurs in up to 80% of patients admitted to intensive care units. Although under-diagnosed, delirium is associated with a significant increase in morbidity and mortality in critical patients.
谵妄的主要特征
(3) disturbance that develops over a short period of time (hours to days) and tends to fluctuate during the course of the day;
(4) evidence of an etiologic factor (ie, delirium due to general medical condition, substance-induced delirium, delirium due to multiple causes, or delirium not otherwise specified)
ICU患者谵妄发生率接近80% 尽管谵妄诊断不足，谵妄与明显增加危重
患者发病率和病死率相关
流行病学
Delirium is common in the ICU, affecting 60% to 80% of mechanically ventilated patients and 20% to 50% of nonmechanically ventilated patients
概念
Delirium in the intensive care unit (ICU) represents an acute form of organ dysfunction,which manifests as a rapidly developing disturbance of both consciousness and cognition that tends to fluctuate throughout the course of a day
谵妄分类--发病时间
The classification of delirium can be subdivided by course over time and motor subtypes.
1.The terminology, according to the course over time, includes
谵妄分类--运动亚型
2.The terminology according to motor subtypes includes
a) hyperactive delirium (in which there is an increase in the psychomotor activity and agitation, with attempts to remove invasive devices);
b) hypoactive delirium (characterized by psychomotor slowing, apathy(淡漠), lethargy（昏睡） and a decrease in response to external stimuli);
(1) disturbance of consciousness with reduced awareness of the environment and impaired ability to focus, sustain, or shift attention;
(2) altered cognition (eg, impaired memory, language disturbance, or disorientation) or the development of a perceptual（知觉） disturbance (eg, hallucinations（幻 觉）, delusions（妄想）, or illusions（错觉）) that is not better accounted for by preexisting or evolving dementia （痴呆）;
b) incident (if it emerges during the hospital length of stay);
and c) persistent (if the symptoms persist over time)
谵妄以急性器官功能障碍为表现形式：倾向于1天 内波动性的、迅速发展的意识和认知紊乱。
谵妄的主要特征
The American Psychiatric Association (APA)Diagnostic and Statistical Manual of Mental Disorders,fourth edition, text revision (DSM-IV) defines 4 key features of delirium:
谵妄在ICU很常见 60-80%机械通气患者发生谵妄 20-50%非机械通气患者发生谵妄
内容
谵妄的流行病学 谵妄概念、主要特征和分类 谵妄的目前关注情况 谵妄的危害 谵妄的风险因素 谵妄评估及诊断 谵妄的预防 谵妄预防的集束化方案--ABCDE方案 谵妄治疗
Delirium
-谵妄
南华大学附属第一医院ICU 王桥生
内容
谵妄的流行病学 谵妄概念、主要特征和分类 谵妄的目前关注情况 谵妄的危害 谵妄的风险因素 谵妄评估及诊断 谵妄的预防 谵妄预防的集束化方案--ABCDE方案 谵妄治疗
Biblioteka Baidu
流行病学
Delirium occurs in up to 80% of patients admitted to intensive care units. Although under-diagnosed, delirium is associated with a significant increase in morbidity and mortality in critical patients.
谵妄的主要特征
(3) disturbance that develops over a short period of time (hours to days) and tends to fluctuate during the course of the day;
(4) evidence of an etiologic factor (ie, delirium due to general medical condition, substance-induced delirium, delirium due to multiple causes, or delirium not otherwise specified)
ICU患者谵妄发生率接近80% 尽管谵妄诊断不足，谵妄与明显增加危重
患者发病率和病死率相关
流行病学
Delirium is common in the ICU, affecting 60% to 80% of mechanically ventilated patients and 20% to 50% of nonmechanically ventilated patients
概念
Delirium in the intensive care unit (ICU) represents an acute form of organ dysfunction,which manifests as a rapidly developing disturbance of both consciousness and cognition that tends to fluctuate throughout the course of a day
谵妄分类--发病时间
The classification of delirium can be subdivided by course over time and motor subtypes.
1.The terminology, according to the course over time, includes
谵妄分类--运动亚型
2.The terminology according to motor subtypes includes
a) hyperactive delirium (in which there is an increase in the psychomotor activity and agitation, with attempts to remove invasive devices);
b) hypoactive delirium (characterized by psychomotor slowing, apathy(淡漠), lethargy（昏睡） and a decrease in response to external stimuli);
(1) disturbance of consciousness with reduced awareness of the environment and impaired ability to focus, sustain, or shift attention;
(2) altered cognition (eg, impaired memory, language disturbance, or disorientation) or the development of a perceptual（知觉） disturbance (eg, hallucinations（幻 觉）, delusions（妄想）, or illusions（错觉）) that is not better accounted for by preexisting or evolving dementia （痴呆）;