在重症监护室内出现反复的妄想发作:发生率和相关因素
Christina Boncyk1, Kimberly Rengel1, Joanna Stollings2
1Department of Anesthesiology, Vanderbilt University Medical Center, United States of America; Critical Illness, Brain Dysfunction, and Survivorship (CIBS) Center, University Medical Center, Vanderbilt, United States of America.
超过10%的重症监护室 (ICU) 患者经历了复发性妄想. 关键因素包括年龄较大,机械通风时间较长和某些药物暴露,突出了重症监护机构的干预领域.
科学领域:
- 关键护理医学 关键护理医学
- 神经科学是一个神经科学.
- 老年病的医生 老年病的医生
背景情况:
- 痴呆症是重症监护室 (ICU) 中常见且严重的并发症.
- 复发性妄想对患者的康复和结果构成重大挑战.
- 了解导致妄想复发的因素对于有效管理至关重要.
研究的目的:
- 为了确定重复 Delirium 在重症监护室 (ICU) 患者的发病率.
- 为了确定患者和医院相关的因素,与复发性妄想相关.
- 为了告知有针对性的干预措施,以防止妄想的复发.
主要方法:
- 追溯性研究分析了8591名患有妄想症的ICU入院患者的数据.
- 妄想的复发定义为48小时无妄想期后的积极评估.
- 多变量逻辑回归用于识别反复 Delirium 的独立预测因素.
主要成果:
- 12.4%的ICU患者患有妄想经历了复发.
- 与复发几率增加相关的因素包括年龄,休克和入院医疗,手术或创伤ICU.
- 长时间的机械通风,使用普罗波福尔和抗精神病药物 (哈洛佩里多尔,奎蒂亚平,奥兰扎宾) 也与复发有关.
结论:
- 经常性妄想会影响超过10%的重症患者.
- 年龄,机械通风的持续时间和暴露于特定药物的时间是显著的危险因素.
- 这些发现强调了需要在ICU中进行警监测和量身定制的预防策略.
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