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首页> 外文期刊>The Canadian journal of hospital pharmacy. >Has the Drug of Choice for Treating Critical Illness Delirium Been Established?: THE 'PRO' SIDE
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Has the Drug of Choice for Treating Critical Illness Delirium Been Established?: THE 'PRO' SIDE

机译：有治疗关键疾病谵妄的首选药物吗？：“亲”一侧

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摘要

Critical illness delirium (hereafter simplified to "delirium") is an acute confusional state seen in up to 80% of adult patients admitted to the intensive care unit (ICU). It is characterized by an altered level of consciousness, changes in cognition, perceptual disturbances, a fluctuating course, disturbances of the sleep—wake cycle, disorientation, psychomotor agitation or retardation, and hallucinations or delusions. As a constellation of symptoms and signs that commonly occur together, delirium should not be considered in and of itself a disease, but rather should be thought of as a syndrome, specifically one of acute brain dysfunction that can typically be traced back to one or more inciting causes. The mainstay of therapy, therefore, must aim to address the underlying causes of the syndrome and not simply treat the symptoms. Just as for a patient presenting with new-onset congestive heart failure it would be inappropriate to treat the symptoms by administering furosemide and oxygen without looking for and treating the underlying cause (e.g., an acute coronary syndrome), the drug of choice for delirium cannot simply be the one that best treats the symptoms; rather, it must address the underlying cause. Therefore, the drug of choice to treat any given case of delirium will be patient- and cause-specific. It could be the antibiotic that targets the patients infection, the free water that addresses the patients hypernatremia, the laxatives that resolve the patients constipation, the benzodiazepine that counters the patients alcohol withdrawal, or the correct treatment that addresses any of the myriad other causes of delirium. The number of potential drivers of delirium is immense, and the reader is encouraged to consult other sources for further information on their assessment and treatment.
机译：临危疾病谵妄（以下简化为“谵妄”）是一种急性对抗状态，可在预计80％的成年患者中达到密集护理单位（ICU）。它的特征在于改变的意识水平，认知，感性紊乱，波动过程，睡眠唤醒循环的干扰，令人惊厥，精神动态搅动或延迟，以及幻觉或妄想的变化。作为常见的症状和迹象的星座，谵妄不应被视为疾病，而是应该被认为是一种综合征，特别是急性大脑功能障碍，通常可以追溯到一个或多个煽动原因。因此，治疗的主要途径必须旨在解决综合征的潜在原因，而不是简单地治疗症状。正如患者呈现出新发起充血性心力衰竭的患者，通过在不寻找和治疗潜在的原因（例如，急性冠状动脉综合征），谵妄的首选药物不能施用和治疗粪便，不能简单地是最能治疗症状的人;相反，它必须解决潜在的原因。因此，治疗任何给定谵妄的选择药物将是患者和原因的。它可能是针对患者感染的抗生素，解决患者高奸癫的自由水，解决患者便秘的泻药，苯二氮卓认为患者酗酒，或解决任何无数其他原因的正确治疗谵妄。谵妄的潜在驱动因素的数量是巨大的，鼓励读者咨询其他来源以获取有关其评估和治疗的进一步信息。

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