Bettelli Gabriella, Neuner Bruno
IRCCS INRCA.
Monaldi Arch Chest Dis. 2017 Jul 18;87(2):842. doi: 10.4081/monaldi.2017.842.
Postoperative delirium (POD) is an acute organic cerebral disturbance of consciousness and attention in combination with additional cognitive symptoms. It usually develops shortly after surgery and lasts for some hours up to some days. It worsens clinical outcomes, prolongs the hospital stay and leads to negative trajectories of cognitive, emotional and functional outcomes up to month if not years after surgery. There are several known predisposing and precipitating factors. Several of them are influenceable. Offering optimal and safe care for an elderly surgery patient requires a team based approach. Strategies for reducing POD incidence include early detection of risk factors, adaptation of surgical and anaesthesiologic techniques, avoiding certain drugs, optimisation of haemostasis, continuously monitoring of the patients' cognitive status as well as early mobilization and careful management of eventual early signs of POD. If POD is prevented, it's negative trajectories may be likewise anticipated.
术后谵妄(POD)是一种急性器质性脑功能障碍,表现为意识和注意力障碍,并伴有其他认知症状。它通常在手术后不久出现,持续数小时至数天。它会恶化临床结局,延长住院时间,并导致术后数月甚至数年的认知、情感和功能结局呈负面轨迹。已知有几个易感因素和促发因素。其中一些是可以控制的。为老年手术患者提供最佳和安全的护理需要团队协作。降低POD发生率的策略包括早期发现危险因素、调整手术和麻醉技术、避免使用某些药物、优化止血、持续监测患者的认知状态以及早期活动和对POD早期迹象的谨慎处理。如果预防了POD,其负面轨迹也可能得到预期改善。