在ICU中的急性脑病变:一种实际的方法
Pedro Kurtz1,2, Mark van den Boogaard3, Timothy D Girard4
1D'Or Institute of Research and Education.
Current opinion in critical care
|March 5, 2024
概括
没有原发性脑损伤的ICU患者的急性脑病变 (AE) 存在诊断和管理方面的挑战. 进展侧重于改进的定义,验证的妄想评估工具,以及EEG和神经成像在昏迷管理中的演变角色.
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.
- 神经学 神经学
背景情况:
- 急性脑病变 (AE) 是重症患者认知状态的快速变化.
- 诊断,监测和管理AE是复杂的,特别是没有初级脑损伤.
- 不断变化的定义澄清了妄想和昏迷,有助于临床评估.
研究的目的:
- 审查在没有初级脑损伤的ICU患者中AE的定义,诊断和管理方面的进展.
- 讨论对AE频谱的治疗选择和结果影响.
- 为了突出目前对这种患者群体的妄想和昏迷的理解.
主要方法:
- 审查关于AE定义和诊断工具的当前文献.
- 对妄和昏迷评估的最新研究结果的分析,包括CAM-ICU ((-7) 和ICDSC.
- 评估治疗策略和EEG和神经成像的作用.
主要成果:
- 妄想是一种波动的神经认知障碍;昏迷是不反应.
- 已验证的工具,如CAM-ICU ((-7) 和ICDSC的援助妄想评估.
- 连续EEG和神经成像越来越多地用于昏迷患者.
结论:
- 痴呆症的药理疗法是有限的;德克斯梅德托米丁在通风患者中显示出有效性.
- 哈洛佩里多尔具有最小的妄想效应,但可能有其他好处.
- 非初级脑损伤中昏迷的特定治疗方法仍然不发达.
相关概念视频
Acute Respiratory Failure-V
138
The treatment for acute respiratory failure varies based on factors like the underlying cause, overall health, and severity. A collaborative healthcare team is essential for early detection, often through arterial blood gas analysis. Identifying the cause is the primary goal, with treatment strategies adjusted for ventilation/perfusion (V/Q) mismatch, shunting, or diffusion impairment.
Ensure that patients are monitored continuously for their response to therapy, including changes in...
Ensure that patients are monitored continuously for their response to therapy, including changes in...
138
Acute Pancreatitis II: Clinical Manifestations and Management
124
Acute pancreatitis presents a complex medical emergency characterized by rapid onset inflammation of the pancreas, demanding timely diagnosis and management to prevent complications. The condition primarily manifests through severe upper abdominal pain that often radiates to the back. This pain intensifies following the consumption of fatty foods. Accompanying symptoms such as nausea, vomiting, abdominal distention, fever, dyspnea, cyanosis, and jaundice can vary in intensity but significantly...
124
Esophageal Varices-II: Clinical Features and Management
66
Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
66


