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Medizinische Klinik - Intensivmedizin und Notfallmedizin

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01.03.2014 | Pflege

Delir auf der Intensivstation

Klinische Wertigkeit, Diagnostik und Therapie

verfasst von: Dr. N. Theuerkauf, DESA, U. Guenther

Erschienen in: Medizinische Klinik - Intensivmedizin und Notfallmedizin | Ausgabe 2/2014

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Zusammenfassung

Das Delir auf der Intensivstation ist eine akute potenziell lebensbedrohliche Organdysfunktion mit einer Inzidenz zwischen 10 und 92 %. Es ist potenziell vermeidbar und hat – auch über den Krankenhausaufenthalt hinaus – einen erheblichen Einfluss auf das Patientenoutcome. Das Delir ist mit persistierenden kognitiven Defiziten, körperlicher Abhängigkeit und Pflegebedürftigkeit, Heimbetreuung sowie einer erhöhten Mortalität assoziiert. Es ist das Ergebnis eines komplexen Zusammenspiels prädisponierender und präzipitierender Faktoren, von denen einige potenziell vermeidbar bzw. behandelbar sind.

Ein Delir wird häufig falsch oder nicht diagnostiziert. Subtyp, Schweregrad und Dauer sind mit der Prognose assoziiert. Sowohl Prävention als auch Behandlung erfordern die tägliche routinemäßige Anwendung eines Screening- und Monitoringverfahrens. Prävention erfordert Risikobewertung: Prädisponierende und auslösende Faktoren sollten erkannt und behandelt werden. Prävention und Behandlungsmöglichkeiten umfassen Verhaltens- und kognitive Trainingsprogramme und möglicherweise entzündungshemmende und antipsychotische Medikamente. Das Auftreten eines Delirs erfordert immer die Suche nach einer zugrundeliegenden Erkrankung, Intoxikation oder Medikamentennebenwirkung.

Diese Übersichtsarbeit gibt einen Überblick über klinische Bedeutung, Risikofaktoren, Pathogenese sowie nichtpharmakologische Möglichkeiten der Prävention und Intervention sowie über etablierte therapeutische Strategien für das Delir auf der Intensivstation.

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Titel: Delir auf der Intensivstation
Klinische Wertigkeit, Diagnostik und Therapie
verfasst von: Dr. N. Theuerkauf, DESA
U. Guenther
Publikationsdatum: 01.03.2014
Verlag: Springer Berlin Heidelberg
Erschienen in: Medizinische Klinik - Intensivmedizin und Notfallmedizin / Ausgabe 2/2014
Print ISSN: 2193-6218
Elektronische ISSN: 2193-6226
DOI: https://doi.org/10.1007/s00063-014-0354-3

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