Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: The complex interplay between delirium, sepsis and sedation. | Kress Critical Care 2010 14 164 http content 14 3 164 CRITICAL CARE COMMENTARY L__ The complex interplay between delirium sepsis and sedation John P Kress See related research by Pandharipande etal. http content 14 2 R38 Abstract Critically ill patients requiring mechanical ventilation frequently suffer from intensive care unit delirium a syndrome associated with numerous poor measured outcomes. The relationship between delirium sepsis and sedation is complex. A discussion of the recent study Effect of dexmedetomidine versus lorazepam on outcome in patients with sepsis an a priori-designed analysis of the MENDS maximizing efficacy of targeted sedation and reducing neurological dysfunction randomized controlled trial by Pandharipande and colleagues is presented in this commentary. Over the past decade we have learned much about the problems associated with acute brain dysfunction during critical illness currently awareness of the ubiquitous presence of intensive care unit ICU delirium is growing. The paper by Pandharipande and colleagues 1 in the previous issue of Critical Care adds insight into this complex area. In 2004 Ely and colleagues 2 published groundbreaking work that identified ICU delirium as an event occurring in over 80 of mechanically ventilated patients those with ICU delirium had a threefold higher independent mortality risk compared with those who never had ICU delirium. Over the last 10 years this group of investigators has worked extensively in the development and validation of the confusion assessment method for the ICU CAM-ICU to detect and better understand ICU delirium. According to this tool delirium is defined as an acute change or fluctuation in the course of mental status plus inattention and either disorganized thinking or an altered level of consciousness 3 . The CAM-ICU tool uses the Richmond Agitation- Correspondence jkress@ Department of Medicine Section of Pulmonary and .
