INTRODUCTION: Delirium is the most prevalent neuropsychiatric syndrome in the general hospital. Its presence is a marker of poor prognosis for patients. Its prevention could be the most effective strategy for reducing its frequency and its complications. OBJECTIVE: To review recent findings and strategies for the prevention of delirium. METHODOLOGY: A non-systematic review of scientific articles published in the last ten years in Spanish and English. A search was made in databases such as MEDLINE, Cochrane, EMBASE, Ovid, and ScienceDirect, for articles that included the terms, delirium and prevention. RESULTS: Identification of predisposing and precipitating factors for delirium and a better understanding of the pathophysiological mechanisms underlying the onset of delirium have enabled the implementation of various pharmacological and non-pharmacological strategies in patients at high risk to develop hospital delirium. The studies to prevent delirium have focused on surgical patients. The current evidence supports the daily implementation of non-pharmacological measures to prevent delirium, as they are easy and cost effective. The available evidence is still limited to recommend the daily use of pharmacological strategies in delirium prophylaxis, and there is a consensus against the modest use of antipsychotic drugs in surgical patients and dexmedetomidine in patients in intensive care. CONCLUSIONS: New high-quality clinical trials and studies involving non-surgical patients are needed to provide more evidence about this subject.
INTRODUCTION:Delirium is the most prevalent neuropsychiatric syndrome in the general hospital. Its presence is a marker of poor prognosis for patients. Its prevention could be the most effective strategy for reducing its frequency and its complications. OBJECTIVE: To review recent findings and strategies for the prevention of delirium. METHODOLOGY: A non-systematic review of scientific articles published in the last ten years in Spanish and English. A search was made in databases such as MEDLINE, Cochrane, EMBASE, Ovid, and ScienceDirect, for articles that included the terms, delirium and prevention. RESULTS: Identification of predisposing and precipitating factors for delirium and a better understanding of the pathophysiological mechanisms underlying the onset of delirium have enabled the implementation of various pharmacological and non-pharmacological strategies in patients at high risk to develop hospital delirium. The studies to prevent delirium have focused on surgical patients. The current evidence supports the daily implementation of non-pharmacological measures to prevent delirium, as they are easy and cost effective. The available evidence is still limited to recommend the daily use of pharmacological strategies in delirium prophylaxis, and there is a consensus against the modest use of antipsychotic drugs in surgical patients and dexmedetomidine in patients in intensive care. CONCLUSIONS: New high-quality clinical trials and studies involving non-surgical patients are needed to provide more evidence about this subject.
Authors: José G Franco; Juan Carlos Molano; Hernán Rincón; Juan David Velasquez Tirado; Carlos Cardeño; Liliana Patarroyo Rodriguez; Gabriel Fernando Oviedo Lugo; Jaime Bernal Miranda; Monica Rojas Moreno Journal: Rev Colomb Psiquiatr (Engl Ed) Date: 2020-12-02
Authors: José G Franco; Juan Carlos Molano; Hernán Rincón; Juan David Velasquez Tirado; Carlos Cardeño; Liliana Patarroyo Rodriguez; Gabriel Fernando Oviedo Lugo; Jaime Bernal Miranda; Monica Rojas Moreno Journal: Rev Colomb Psiquiatr (Engl Ed) Date: 2022-09-01