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Delirium

Delirium is a life-threatening and highly underdiagnosed condition. It is a reaction of CNS to damage, manifested by a qualitative impairment of consciousness, decreased attention. Delirium usually starts suddenly in the evening and has a fluctuating course. It can have many causes: organic, toxic (caused by the administration of anticholinergics, dopaminergic antiparkinsonian drugs), and may be caused by withdrawal state as well (D. tremens). According to symptoms we distinguish hypoactive, hyperactive or mixed delirium.

Author: Marek Kovář, Zuzana Timková, Richard Izák, Mária Štefíčková

Institution: Faculty of Medicine at Masaryk University in Brno

Medical discipline: Emergency Medicine

Keywords: hyperactive delirium | hypoactive delirium | mixed delirium | CAM-ICU form | multimodal non-pharmacological prevention

Educational evel: Undergraduate level | Graduate

Delirium is a life-threatening and highly underdiagnosed condition. It is a reaction of CNS to damage, manifested by a qualitative impairment of consciousness, decreased attention. Delirium usually starts suddenly in the evening and has a fluctuating course. It can have many causes: organic, toxic (caused by the administration of anticholinergics, dopaminergic antiparkinsonian drugs), and may be caused by withdrawal state as well (D. tremens). According to symptoms we distinguish hypoactive, hyperactive or mixed delirium.


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Review

Delirium is a common complication of critically ill patients, most often during the postoperative period in patients over 65 years. Many factors, such as infection, systemic inflammatory response, metabolic disruption, hypoxemia, insufficient analgetic therapy after surgery, are critical for the development of brain dysfunction - delirium. Its onset significantly worsens the therapy outcomes, mortality and morbidity of patients. With quick diagnostics and knowledge of risk factors, it can be partially prevented.
The Delirium virtual scenario clearly displays the main characteristics of delirium (hyperactive, hypoactive - silent and mixed delirium), its risk factors and options for prevention and subsequent treatment. The algorithm allows us to practice this issue from diagnostics to a multi-component therapy with frequent reorientation, sufficient analgesia, or correctly choosen analgosedation, hydratation, early rehabilitation and other measures. This allows us to take better care of our patients.

publikováno: 8.5.2020 | last modified on: 9.6.2020