ICU谵妄PPT精品文档.ppt

葡萄牙版本of CAM-ICU English versions of CAM-ICU RASS评分 谵妄评分工具有效性 谵妄鉴别诊断 内容 谵妄的流行病学 谵妄概念、主要特征和分类 谵妄的危害 谵妄的风险因素 谵妄评估及诊断 谵妄的预防 谵妄预防的集束化方案--ABCDE方案 谵妄治疗 ICU谵妄预防 On the whole, the constellation（系列） of risk factors for delirium affecting individual ICU patients varies from patient to patient and thus an individualized （个性化）strategy for delirium prevention should be sought 3 risk factors in particular, sedatives,（镇静药物） immobility,（无法移动） and sleep disruption, are widespread in the ICU 苯二氮卓类药物使用是发生谵妄的危险因素 avoidance of benzodiazepines（苯二氮卓类） is an important strategy when seeking to both prevent delirium and reduce its duration. 通过疼痛管理预防谵妄 Pain is a modifiable（更改）risk factor for delirium, and inadequate pain control is a frequent cause for agitation in the ICU. When pain is not assessed and treated, patients may be inappropriately given a sedative medication rather than an analgesic（止痛） medication. In summary, these data suggest that opioids(阿片类) used to treat pain are protective against the development of delirium, whereas those used at doses high enough to cause sedation（镇静） may increase the risk of delirium. Therefore, patients should undergo regular pain assessments（疼痛评估）, and when pain is detected, effective doses of an analgesic medication （镇痛药物）should be given, taking care to avoid inducing heavy sedation(诱导镇静）. Delirium -谵妄诊断及ABCDE 谵妄预防策略 南华大学附属第一医院ICU 黄丽萍 内容 谵妄的流行病学 谵妄概念、主要特征和分类 谵妄的危害 谵妄的风险因素 谵妄评估及诊断 谵妄的预防 谵妄预防的集束化方案--ABCDE方案 谵妄治疗 流行病学 Delirium occurs in up to 80% of patients admitted to intensive care units Although under-diagnosed, delirium is associated with a significant increase in morbidity and mortality in critical patients. ICU患者谵妄发生率接近80% 尽管谵妄诊断不足，谵妄与明显增加危重患者发病率和病死率相关 流行病学 Delirium is common in the ICU, affecting 60% to 80% of mechanically ventilated patients and 20% to 50% of nonmechanically ventilated patients 谵妄在ICU很常见 60-80%机械通气患者发生谵妄 20-50%非机械通气患者发生谵妄 内容 谵妄的流行病学 谵妄概念、主要特征和分类 谵妄的危害 谵妄的风险因素 谵妄评估及诊断 谵妄的预防 谵妄预防的集束化方案--ABCDE方案 谵妄治疗 概念 Delirium in the