Postoperative confusion at ICU – an important perioperative complication in older patients


Authors: J. Bruthans 1;  D. Bruthansová 2;  M. Svítek 1
Authors‘ workplace: KARIM, 1. LF UK a VFN 1;  VÚPSV v. v. i. 2
Published in: Čes Ger Rev 2009; 7(2): 68-74

Overview

Postoperative delirium is a complication in the perioperative period that affects usually patients aged 65 and older. Multiple negative events usually occure in deliri ous pati ent –  e. g. inadvert extracti on of catheters or endotracheal tube, lenghtening of hospitalizati on and increse of costs, mortality growth and potenti onally even long‑term worsening of cognitive functi ons. Due to multifactori al re asons of such a state, a complex approach to preventi on and therapy of postoperative deliri um is required. Basically, the burden of the operati on, disturbati on of soci al settings and disturbati on of pati ent’s bi orythms sho ud be diminished and drugs (especi ally ne uroleptic drugs) sho uld be administred with cauti on. In case of development of postoperative deliri um first signs sho uld be recognised and tre ated, possibly with suitable psychological appro ach. An appropri ate behavi o ur of staff is of the utmost importance. Also relatives might be helpful and a sensitive appro ach to them is necessary. Further tre atment includes antipsychotic drugs, controversi al movement restricti on by harnesses and sedating of the pati ent, even to the extent of general anesthesi a.

Keywords

postoperative deliri um –  delirant syndrom –  older paci ent –  complicati on postoperative –  restrictive me asures


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Labels
Geriatrics General practitioner for adults
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