Pathophysiology of delirium in the intensive care unit

被引：137

作者：

Gunther, Max L. ^{[1
,2
,3
]}

Morandi, Alessandro ^{[1
,4
,5
]}

Ely, E. Wesley ^{[1
,2
]}

机构：

[1] Vanderbilt Univ Sch Med, Ctr Hlth Serv Res, Nashville, TN 37232 USA

[2] VA Tennessee Valley Geriatr Res Educ & Clin Ctr, Nashville, TN 37212 USA

[3] Univ Georgia, Dept Psychol, Athens, GA 30602 USA

[4] Poliambulanza Hosp, Dept Internal Med & Geriatr, I-25100 Brescia, Italy

[5] Geriatr Res Grp, I-25122 Brescia, Italy

来源：

CRITICAL CARE CLINICS | 2008年 / 24卷 / 01期

关键词：

D O I：

10.1016/j.ccc.2007.10.002

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Delirium, or acute brain dysfunction, is a life-threatening global disturbance in cognitive functioning that frequently manifests in critically ill patients. This review examines the current status of knowledge regarding the pathophysiology of delirium in the ICU, in particular, evaluating the role of iatrogenic factors such as sedatives and analgesic administration in brain dysfunction. This hypothesis is considered along with several other plausible mechanisms of ICU delirium, including sepsis, postoperative cognitive dysfunction, and changes in biomarkers and neuro-transmitters. The review concludes by highlighting potential future directions in molecular genetics for the elucidation of delirium and its long-term consequences.

引用

页码：45 / +

页数：22

共 175 条

[1] Serum S100 protein as a marker of cerebral damage during cardiac surgery [J].

Ali, MS ;

Harmer, M ;

Vaughan, R .

BRITISH JOURNAL OF ANAESTHESIA, 2000, 85 (02) :287-298

[2] The role of neuroimaging in elucidating delirium pathophysiology [J].

Alsop, David C. ;

Fearing, Michael A. ;

Johnson, Keith ;

Sperling, Reisa ;

Fong, Tamara G. ;

Inouye, Sharon K. .

JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES, 2006, 61 (12) :1287-1293

[3] Neuron-specific enolase as a marker for acute ischemic stroke: A systematic review [J].

Anand, N ;

Stead, LG .

CEREBROVASCULAR DISEASES, 2005, 20 (04) :213-219

[4] Exposure to anaesthetic agents, cognitive functioning and depressive symptomatology in the elderly [J].

Ancelin, ML ;

De Roquefeuil, G ;

Ledésert, B ;

Bonnel, F ;

Cheminal, JC ;

Ritchie, K .

BRITISH JOURNAL OF PSYCHIATRY, 2001, 178 :360-366

[5] Poly(ADP-ribose) (PAR) polymer is a death signal [J].

Andrabi, Shaida A. ;

Kim, No Soo ;

Yu, Seong-Woon ;

Wang, Hongmin ;

Koh, David W. ;

Sasaki, Masayuki ;

Klaus, Judith A. ;

Otsuka, Takashi ;

Zhang, Zhizheng ;

Koehler, Raymond C. ;

Hurn, Patricia D. ;

Poirier, Guy G. ;

Dawson, Valina L. ;

Dawson, Ted M. .

PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA, 2006, 103 (48) :18308-18313

[6]

[Anonymous], 2000, DIAGN STAT MAN MENT, DOI DOI 10.1176/APPI.BOOKS.9780890425787

[7] Role of tau protein in both physiological and pathological conditions [J].

Avila, J ;

Lucas, JJ ;

Pérez, M ;

Hernández, F .

PHYSIOLOGICAL REVIEWS, 2004, 84 (02) :361-384

[8] The relation between the clinical subtypes of delirium and the urinary level of 6-SMT [J].

Balan, S ;

Leibovitz, A ;

Zila, SO ;

Ruth, M ;

Chana, W ;

Yassica, B ;

Rahel, B ;

Richard, G ;

Neumann, E ;

Blagman, B ;

Habot, B .

JOURNAL OF NEUROPSYCHIATRY AND CLINICAL NEUROSCIENCES, 2003, 15 (03) :363-366

[9]

Beier Manju T, 2005, J Am Med Dir Assoc, V6, P413, DOI 10.1016/j.jamda.2005.08.008

[10]

Black KJ, 2002, J NEUROPSYCHIATR CLI, V14, P118

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