COVID-19: What do we need to know about ICU delirium during the SARS-CoV-2 pandemic?
COVID-19: What do we need to know about ICU delirium during the SARS-CoV-2 pandemic?
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DOI：
10.5114/ait.2020.95164
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发表时间：
2020
影响因子：
1.7
通讯作者：
Dabrowski W
中科院分区：
文献类型：
--
作者：
Kotfis K;Williams Roberson S;Wilson J;Pun B;Ely EW;Jeżowska I;Jezierska M;Dabrowski W
2020年3月，世界卫生组织宣布了由SARS-CoV-2病毒引起的COVID-19大流行。除了呼吸衰竭，SARS-CoV-2还可能导致中枢神经系统（CNS）受累，包括危重患者发生的谵妄（ICU谵妄）。面对COVID-19大流行，必须适当关注此议题。谵妄的检测需要不到两分钟的时间，在日常ICU护理中经常被低估，但它可能是与严重呼吸衰竭相关的感染或缺氧的前驱症状。在COVID-19大流行期间，使用经验证的测试（CAM-ICU或ICDSC）进行的系统性谵妄监测可能会被牺牲。这可能是由于主要重点放在组织问题上，即缺乏通风设备，为有限的机械通风选择确定优先顺序，以及缺乏个人防护设备。在COVID-19患者中，早期识别谵妄患者至关重要，因为谵妄的发生可能是呼吸衰竭恶化或由冠状病毒的潜在神经侵袭机制介导的CNS感染性传播的早期症状。本综述的目的是确定COVID-19流行期间与谵妄发展相关的问题，这些问题在三个方面提出：i）COVID-19谵妄的促成因素，ii）COVID-19谵妄的潜在病理生理因素，以及iii）COVID-19谵妄的长期后果。本文讨论了医护人员如何通过识别与SARS-CoV-2感染相关的挑战中的潜在风险因素和困难来减轻谵妄的负担。
In March 2020, the World Health Organisation announced the COVID-19 pandemic caused by the SARS-CoV-2 virus. As well as respiratory failure, the SARS-CoV-2 may cause central nervous system (CNS) involvement, including delirium occurring in critically ill patients (ICU delirium). Due attention must be paid to this subject in the face of the COVID-19 pandemic. Delirium, the detection of which takes less than two minutes, is frequently underestimated during daily routine ICU care, but it may be a prodromal symptom of infection or hypoxia associated with severe respiratory failure. During the COVID-19 pandemic, systematic delirium monitoring using validated tests (CAM-ICU or ICDSC) may be sacrificed. This is likely to be due to the fact that the main emphasis is placed on organisational issues, i.e. the lack of ventilators, setting priorities for limited mechanical ventilation options, and a shortage of personal protective equipment. Early identification of patients with delirium is critical in patients with COVID-19 because the occurrence of delirium may be an early symptom of worsening respiratory failure or of infectious spread to the CNS mediated by potential neuroinvasive mechanisms of the coronavirus. The purpose of this review is to identify problems related to the development of delirium during the COVID-19 epidemic, which are presented in three areas: i) factors contributing to delirium in COVID-19, ii) potential pathophysiological factors of delirium in COVID-19, and iii) long-term consequences of delirium in COVID-19. This article discusses how healthcare workers can reduce the burden of delirium by identifying potential risk factors and difficulties during challenges associated with SARS-CoV-2 infection.
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影响因子：
8.8
作者：
Girard TD;Jackson JC;Pandharipande PP;Pun BT;Thompson JL;Shintani AK;Gordon SM;Canonico AE;Dittus RS;Bernard GR;Ely EW
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