Bệnh Nhiễm trùng huyết thiếu oxy Mức độ nghiêm trọng yếu tố chuyển hóa rối loạn của điểm số bệnh Iatrogenic / yếu tố môi trường thuốc an thần, thuốc giảm đau sử dụng của các loại thuốc ống thông bàng quang kháng acetylcholin giấc ngủ chất lượng / số lượng | 212 SEMINARS IN RESPIRATORY AND CRITICAL CARE MEDICINE VOLUME 27 NUMBER 3 2006 Table 1 Risk Factors for Delirium Baseline Characteristics Disease Factors Iatrogenic Environmental Factors Cognitive impairment Comorbidities Age Sepsis Hypoxemia Metabolic derangements Severity of illness score Sedative medications Analgesic medications Use of bladder catheter Anticholinergic medications Sleep quality quantity Adapted from Pandharipande et See American Psychiatric Association Practice guidelines for the treatment of delirium for more ventilation which begets sedatives and or narcotics to ensure patient comfort and patient-ventilator synchrony. Those patients who do not require mechanical ventilation frequently still evidence frequent disruptions of sleep . from alarming monitors or intravenous pumps blood draws bathing or changes in positioning to prevent decubitus ulcer formation moreover nonventilated ICU patients not uncommonly still require sedatives or narcotics and suffer multiple organ dysfunctions. For practicality and simplicity we divide proven or potential risk factors among three categories 1 host characteristics 2 features of the acute illness and 3 environmental or iatrogenic factors Table 1 .27a The accumulation of risk factors likely portends development of delirium. In separate cohorts of non-ICU patients Francis et al28 and Inouye and Charpentier29 noted at least a 60 risk of developing delirium among patients with three or more risk factors. Critically ill patients easily have at least three risk factors. In fact in a study of 53 consecutive medical ICU patients Ely et al discovered that each patient had a mean standard deviation of 11 4 delirium risk factors with a range of three to The accumulation of risk factors in critically ill patients undoubtedly contributes to a high prevalence of delirium. Perhaps the most universal and potentially modifiable risk factor among critically ill patients is exposure to psychoactive .
