Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Dealing with the delirium dilemma. | Available online http content 9 4 335 Commentary Dealing with the delirium dilemma Kees H Polderman and Ellen Smit Senior consultant in Intensive Care Medicine Department of Intensive Care VU University Medical Center Amsterdam The Netherlands Corresponding author Kees H Polderman Published online 17 June 2005 This article is online at http content 9 4 335 2005 BioMed Central Ltd Critical Care 2005 9 335-336 DOI cc3755 See related research by Thomason et al. in this issue http 9 4 R375 Abstract Delirium is a frequently occurring but often under-diagnosed and under-treated problem in the intensive care unit ICU . It has been linked to adverse outcome increased length of stay and higher mortality in critically ill patients. A study by Thomason and coworkers published in this issue of Critical Care deals with the issue of delirium and its consequences in less severely ill patients. This commentary aims to provide context for this study discussing its potential implications as well as the potential therapeutic and preventive measures in patients with hyperactive or hypoactive delirium Until the early 1990s it was common practice to administer large doses of sedatives analgetics and neuromuscular blocking agents NMBAs routinely to mechanically ventilated patients. The underlying assumption was that without such medications patients could not tolerate invasive intensive care unit ICU treatments and that sedation and paralysis would allow the patient to rest and recover. Practices and treatments used for general anaesthesia during major surgery were often simply continued for longer term management in the ICU. This attitude began to change in the mid-1990s with the realization that prolonged use of high-dose NMBAs sedatives and opiates was associated with increased risk for critical illness polymyoneuropathy nosocomial infections adverse outcomes and increased length of stay LOS in the ICU. Kress and .
