ПРОФІЛАКТИКА ТА ПЕРІОПЕРАЦІЙНИЙ СКРИНІНГ ПІСЛЯОПЕРАЦІЙНОГО ДЕЛІРІЮ СЕРЕД УРГЕНТНИХ ПАЦІЄНТІВ ПОХИЛОГО ВІКУ

Демитер І. М., Воротинцев С. І., Доля О. С., Гудзь Д. П.

ОГЛЯДИ ЛІТЕРАТУРИ

Наукова стаття

Післяопераційний делірій (ПОД) – неспецифічний поліетіологічний синдром, який проявляється переміжними порушеннями уваги, свідомості, мислення та сприйняття, дезорієнтацією, порушенням циклу сон-неспання та видозміненою психо-моторною активністю. Інцидентність ПОД неоднорідна в залежності від типу хірургії та ризику оперативного втручання і варіює від 3% до 75%. Післяопераційний делірій може розвиватися з 1-3 дня після операції та тривати до п’яти діб. Враховуючи переміжний характер перебігу делірію, оцінку рівня седації та ажитації, за шкалою Річмонда, слід починати ще в ранньому післяопераційному періоді. Профілактика – це найбільш ефективна стратегія мінімізації негативних наслідків ПОД.

післяопераційний делірій, пацієнти похилого віку

1. Korc-Grodzicki B, Root JC, Alici Y. Prevention of post-operative delirium in older patients with cancer undergoing surgery. J Geriatr Oncol. 2015;6(1):60-9. DOI: 10.1016/j.jgo.2014.10.002
2. Inouye SK, Foreman MD, Mion LC, Katz KH, Cooney LM Jr. Nurses‘ recognition of delirium and its symptoms: comparison of nurse and researcher ratings. Arch Intern Med. 2001;161(20):2467-73.
3. Marcantonio ER. Postoperative delirium: a 76-year-old woman with delirium following surgery. JAMA. 2012;308:73-81.
4. Marcantonio ER. In the clinic: delirium. Ann Intern Med. 2011;154:ITC6-1-ITC6-1.
5. Cavaliere F, D’Ambrosio F, Volpe C, Masieri S. Postoperative delirium. Curr Drug Targets. 2005;6:807-14.
6. Fong TG, Tulebaev SR, Inouye SK. Delirium in elderly adults: Diagnosis, prevention and treatment. Nat Rev Neurol. 2009;5:210-20.
7. Segal-Gidan, Freddi PA. Postoperative confusion in older adults. Journal of the American Academy of Pas. 2017;30(4):12-6.
8. Agostini JV, Inouye SK. Delirium. In: Hazzard WR, Blass JP, Halter JB, Ouslander JG, Tinetti ME, editors. Principles of geriatric medicine and gerontology. 5th ed. New York: McGraw-Hill; 2003. р. 1503-15.
9. Pisani MA, McNicoll L, Inouye SK. Cognitive impairment in the intensive care unit. Clin Chest Med. 2003;24:727-37.
10. American Psychiatric Association. Practice guideline for the treatment of patients with delirium. Am J Psychiatry.1999;156:1-20.
11. Moran JA, Dorevitch MI. Delirium in the hospitalized elderly. Aust J Hosp Pharm. 2001;31:35-40.
12. Figueroa-Ramos M, Arroyo-Novoa C, Lee K, Padilla G, Puntillo K. Sleep and delirium in ICU patients: A review of mechanisms and manifestations. Intensive Care Med. 2009;35:781-95.
13. Audrey Miang Ying Tan, Derek Amoako. Postoperative cognitive dysfunction after cardiac surgery. Contin. Educ. Anaesth. Crit. Care Pain. 2013;13(6):218-23.
14. Sanders RD, Pandharipande PP, Davidson AJ, Ma D, Maze M. Anticipating and managing postoperative delirium and cognitive decline in adults. BMJ. 2011;343:4331.
15. Cesar Aldecoa, Gabriella Bettelli, Federico Bilotta, Robert D. Sanders, Riccardo Audisio, Anastasia Borozdina, et al. European Society of Anaesthesiology evidence-based and consensus-based guidelines on postoperative delirium. Eur. J. Anaesthesiol. 2017;34:1-23.
16.  Inouye SK. Delirium in older persons. N Engl J Med. 2006;354:1157-65.
17. Chaput AJ, Bryson GL. Postoperative delirium: Risk factors and management: Continuing professional development. Can J Anaesth. 2012;59:304-20.
18. Trembach NV. Anesthesia in patients with concomitant diseases of the central nervous system: a review of the literature. Vestnik intensivnoy terapii. 2017;3:19-34.
19. Chow WB, Rosenthal RA, Merkow RP, Ko CY, Esnaola NF. American College of Surgeons National Surgical Quality Improvement Program et al. Optimal preoperative assessment of the geriatric surgical patient: a best practices guideline from the American College of Surgeons National Surgical Quality Improvement Program and the American Geriatrics Society. J Am Coll Surg. 2012;215(4):453-66. Available from: https://doi.org/10.1016/j.jamcollsurg.2012.06.017
20. Borson S, Scanlan J, Brush M, Vitaliano P, Dokmak A. The Mini-Cog: a cognitive «vital signs» measure for dementia screening in multilingual elderly. Int J Geriatr Psychiatry. 2000;15(11):1021-7
21. .Weinhouse GL, Schwab RJ. Sleep in the critically ill patient. Sleep. 2006;29:707-16.
22. Lina De Geer, Mats Fredrikson, Anna O. Tibblin. Frailty predicts 30-day mortality in intensive care patients. Eur J Anaesthesiol. 2020;37:1-8.
23. Ushida T, Yokoyama T, Kishida Y, Hosokawa M, Taniguchi S, Inoue S, et al. Incidence and risk factors of postoperative delirium in cervical spine surgery. Spine (Phila Pa 1976). 2009;34:2500-4.
24. Dovjak P, Iglseder B, Mikosch P, Gosch M, Müller E, Pinter G, et al. Treatment and prevention of postoperative complications in hip fracture patients: infections and delirium. Wien Med Wochenschr. 2013;163:448-54.
25. Kip MJ, Neumann T, Jugel C, Kleinwaechter R, Weiss-Gerlach E, Guill MM, et al. New strategies to detect alcohol use disorders in the preoperative assessment clinic of a German university hospital. Anesthesiology. 2008;109:171-9.
26. Hirsch J, DePalma G, Tsai TT, Sands LP, Leung JM. Impact of intraoperative hypotension and blood pressure fluctuations on early postoperative delirium after noncardiac surgery. Br J Anaesth. 2015;115:418-26.
27. Ely EW. The ABCDEF Bundle: Science and Philosophy of How ICU Liberation Serves Patients and Families. Crit Care Med. 2017;45(2):321- 30. Available from: https://www.sccm.org/ICULiberation/ABCDEF-Bundles/Pain
28. Barnes-Daly MA, Phillips G, Ely EW. Improving Hospital Survival and Reducing Brain Dysfunction at Seven California Community Hospitals: Implementing PAD Guidelines Via the ABCDEF Bundle in 6,064 Patients. Crit Care Med. 2017;45(2):171-8. Available from: https:// www.sccm.org/ICULiberation/Resources/Numerical-Pain-Rating-Scale-(NRS)
29. Miller MA, Govindan S, Watson SR. ABCDE, but in that order? A cross-sectional survey of Michigan intensive care unit sedation, delirium, and early mobility practices. Ann Am Thorac Soc. 2015;12(7):1066-71. Available from: https://www.sccm.org/ICULiberation/Resources/ Behavioral-Pain-Scale-(BPS)
30. Morandi A, Brummel NE, Ely EW. Sedation, delirium and mechanical ventilation: the ‘ABCDE’ approach. Curr Opin Crit Care. 2011;17(1):43- 9. Available from: https://www.sccm.org/ICULiberation/Resources/Critical-Care-Pain-Observation-Tool-(CPOT)
31. Barnes-Daly MA, Pun BT, Harmon LA. Improving Health Care for Critically Ill Patients Using an Evidence-Based Collaborative Approach to ABCDEF Bundle Dissemination and Implementation. Worldviews Evid Based Nurs. 2018;15(3):206-16. Available from: https://www.sccm. org/ICULiberation/ABCDEF-Bundles/Pain
32. Hwang BM. Intravenous patient-controlled analgesia has a positive effect on the prognosis of delirium in patients undergoing orthopedic surgery. Korean J Pain. 2014;27:271-7.
33. Clinical Practice Guideline for Postoperative Delirium in Olde Adults. The American Geriatrics Society Expert Panel on Postoperative Delirium in Older Adults. Available from: http:/www.geriatricscareonline.org/toc/postoperative_deliriumCL018
34. Sieber F, Pauldine R. Geriatric anesthesia. In: Miller RD, editor. Miller’s Anesthesia. 8th ed. Philadelphia: Elsevier Churchill Livingstone. 2015;2:2412-4.
35. McCusker J, Cole M, Abrahamowicz M, Primeau F, Belzile E. Delirium predicts 12-month mortality. Arch Intern Med. 2002;162:457-63.
36. Meagher DJ, Leonard M, Donnelly S, Conroy M, Adamis D, Trzepacz PT. A longitudinal study of motor subtypes in delirium: Relationship with other phenomenology, etiology, medication exposure and prognosis. J Psychosom Res. 2011;71:395-403.
37. Sessler CN, Gosnell MS, Grap MJ, Brophy GM, O’Neal PV, Keane KA, et al. The Richmond Agitation-Sedation Scale: validity and reliability in adult intensive care unit patients. Am J Respir Crit Care Med. 2002;166:1338-44.
38. Ely EW, Margolin R, Francis J, May L, Truman B, Dittus R, et al. Evaluation of delirium in critically ill patients: validation of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). Crit. Care Med. 2001;29:1370-9.
39. Gaudreau JD, Gagnon P, Harel F. Tremblay A, Roy MA. Fast, systematic, and continuous delirium assessment in hospitalized patients: The Nursing Delirium Screening Scale. J. Pain Symptom Manage. 2005;29:368-75.
40. Fong TG, Tulebaev SR, Inouye SK. Delirium in elderly adults: Diagnosis, prevention and treatment. Nat Rev Neurol. 2009;5:210-20.
41. Saczynski JS, Marcantonio ER, Quach L, Fong TG, Gross A, Inouye SK, et al. Cognitive trajectories after postoperative delirium. N Engl J Med. 2012;367:30-9.
42. BellelliG, Mazzola P, Morandi A. Duration of postoperative delirium is an independent predictor of 6-month mortality in older adults after hip fracture. J Am Geriatr Soc. 2014;62:1335-40.
43. Björkelund KB, Hommel A, Thorngren KG, Gustafson L, Larsson S, Lundberg D. Reducing delirium in elderly patients with hip fracture: A multi-factorial intervention study. Acta Anaesthesiol Scand. 2010;54:678-88.
44. Zaubler TS, Murphy K, Rizzuto L, Santos R, Skotzko C, Giordano J. Quality improvement and cost savings with multi component delirium interventions: Replication of the Hospital Elder Life Program in a community hospital. Psychosomatics. 2013;54:219-26.
45. Robinson S, Vollmer C. Undermedication for pain and precipitation of delirium. Medsurg Nurs. 2010;19:79-83.
46. Leung JM, Sands LP, Rico M, Petersen KL, Rowbotham MC, Dahl JB, et al. Pilot clinical trial of gabapentin to decrease postoperative delirium in older patients. Neurology. 2006;67:1251-3.
47. Krenk L, Rasmussen LS, Hansen TB, Bogø S, Søballe K, Kehlet H. Delirium after fast-track hip and knee arthroplasty. Br J Anaesth. 2012;108:607-11.
48. Mouzopoulos G, Vasiliadis G, Lasanianos N, Nikolaras G, Morakis E, Kaminaris M. Fascia iliaca block prophylaxis for hip fracture patients at risk for delirium: A randomized placebo-controlled study. J Orthop Traumatol. 2009;10:127-33.
49. Kinjo S, Lim E, Sands LP, Bozic KJ, Leung JM. Does using a femoral nerve block for total knee replacement decrease postoperative delirium? BMC Anesthesiol. 2012;12:4.

«Вістник проблем біології і медицини» Випуск 2 (156), 2020 рік , 22-26 сторінки, код УДК 616-089.166-06:[616.89-008.452-053.9-02:616-089]]-07-084

10.29254/2077-4214-2020-2-156-22-26