[Postoperative delirium and cognitive deficit. Prevention and therapy].

To date, there are few studies available focusing on prevention and therapy of delirium in ICU patients. Monitoring during routine care is important because without using validated tools only one third of the delirious patients will be detected. A lot of non-pharmacological interventions like re-orientation and helping the patient to get back his autonomy, but also goal-orientated sedation support prevention and therapy of delirium. Furthermore, there are hints that pharmacological intervention can reduce incidence and severity of delirium. For delirium prevention there are drugs available acting on different receptor systems (acetylcholine, dopamine, opioid, glutamate). For the use of this drugs, a strict risk-benefit-consideration is necessary due to the low level of evidence of the existing studies. Therapeutically causative and symptom-orientated approaches should be preferred. Georg Thieme Verlag Stuttgart * New York.