importância da monitorização do delirium na unidade de terapia intensiva the importance of delirium monitoring in the intensive care unit

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ID: 200518
2010
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Abstract
O delirium é um estado confusional agudo associado a maior mortalidade na unidade de terapia intensiva e comprometimento da recuperação funcional em longo prazo. Apesar de sua elevada incidência e relevante impacto nos desfechos de pacientes criticamente enfermos, o delirium continua sendo sub-diagnosticado. Atualmente existem instrumentos validados para diagnosticar e monitorar o delirium, permitindo a detecção precoce dessa disfunção orgânica e início precoce do tratamento. Além dos fatores de risco não modificáveis do paciente, existem aspectos clínicos e ambientais modificáveis que devem ser avaliados para reduzir a ocorrência e gravidade do delirium. Conforme demonstrado por estudos recentes, intervenções para reduzir a exposição a sedatição excessiva e melhorar a orientação do paciente podem estar associadas a redução da incidência de delirium. Baixa incidência de delirium deve ser almejada e considerada como uma medida da qualidade nas unidades de terapia intensiva.
Delirium is an acute confusional state associated with increased mortality in the intensive care unit and long-term impaired functional recovery. Despite its elevated incidence and major impact in the outcomes of critically ill patients, delirium remains under-diagnosed. Presently, there are validated instruments to diagnose and monitor delirium, allowing the detection of early organ dysfunction and treatment initiation. Beyond patient's non-modifiable risk factors, there are modifiable clinical and environmental aspects that should be accessed to reduce the occurrence and severity of delirium. As recent studies demonstrate that interventions aiming to reduce sedative exposure and to improve patients' orientation associated with early mobility have proved to reduce delirium, a low incidence of delirium should be targeted and considered as a measure of quality of care in the intensive care unit (ICU).
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Authors ;Melissa Tassano Pitrowsky;Cássia Righy Shinotsuka;Marcio Soares;Marco Antonio Sales Dantas Lima;Jorge Ibrain Figueira Salluh
Journal Database : the journal of biological databases and curation
Year 2010
DOI
10.1590/S0103-507X2010000300010
URL
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0103-507X2010000300010
Keywords
delirium confusion critical care first aid intensive care intensive care unitsmedical emergencies

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