在重症监护病房中改变精神状态的方法
Catherine S W Albin1, Cheston B Cunha2,3, Timlin P Glaser4,5
1Emory University School of Medicine, Atlanta, Georgia.
Seminars in neurology
|August 13, 2024
概括
在ICU中改变精神状态 (AMS) 需要特定的诊断,而不仅仅是综合征标签,如有毒代谢性脑病变 (TME). 本综述指导临床医生在重症患者中确定AMS可治疗的原因.
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.
- 内部医学 内部医学
背景情况:
- 改变精神状态 (AMS) 是重症监护室 (ICU) 中常见且负担重重的综合征.
- 患有AMS的患者经常被诊断为具有非特异性标签,例如有毒代谢性脑病变 (TME) 或妄.
- 迫切需要在重症患者中确定AMS的特定,可治疗的病因.
研究的目的:
- 为确定重症患者AMS的特定原因提供一个结构化的方法.
- 提供在ICU环境中对病床临床评估的实际指导.
- 审查神经诊断程序在不稳定患者中诊断AMS的实用性.
主要方法:
- 关于在ICU中AMS的原因和诊断的文献综述.
- 讨论临床评估技术和神经诊断程序.
- 专注于AMS的高产量毒理学,神经学和传染病病因.
主要成果:
- 一种结构化的方法可以提高识别AMS的特定原因.
- 床边评估和专门的神经诊断模式在ICU中是有价值的.
- 具体的病因,包括尿性和败血性脑病变,以及其他高收益率的原因,需要刻意考虑.
结论:
- 对特定病因的系统评估对于在ICU中管理AMS至关重要.
- 临床医生应该超越非特异性诊断,以确保适当的治疗.
- 本综述为诊断和管理重症患者的AMS提供了一个框架.
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