Intensive Care Unit Delirium: A Review of Diagnosis, Prevention, and Treatment.
Intensive Care Unit Delirium: A Review of Diagnosis, Prevention, and Treatment.
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DOI：
10.1097/aln.0000000000001378
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发表时间：
2016-12
期刊：
影响因子：
8.8
通讯作者：
Hughes CG
中科院分区：
文献类型：
--
作者：
Hayhurst CJ;Pandharipande PP;Hughes CG
一名77岁的男性在髋部骨折后入院。患者既往有慢性阻塞性肺疾病、高血压、高脂血症、慢性背痛和听力损失病史。在手术前，他接受咪达唑仑用于激动和吗啡用于疼痛控制。他接受全身麻醉进行骨折修复，需要高剂量的芬太尼来控制疼痛。术后，他的肺力学较差，被送往ICU插管和机械通气。术后第一天，他的镇静剂被解除，并进行自主呼吸试验。当他间歇性地清醒时，他不会听从命令，只是间歇性地进行眼神交流。患者由于精神状态改变而留下插管。
A 77 year-old male is admitted to the hospital after sustaining a hip fracture. He has a past medical history of chronic obstructive pulmonary disease, hypertension, hyperlipidemia, chronic back pain, and hearing loss. Prior to surgery he receives midazolam for agitation and morphine for pain control. He undergoes a general anesthetic for his fracture repair, requiring high doses of fentanyl for pain control. Postoperatively, he has poor pulmonary mechanics and is taken to the ICU intubated and mechanically ventilated. On postoperative day one, his sedation is weaned and he is put on a spontaneous breathing trial. While he appears intermittently awake, he will not follow commands and only intermittently makes eye contact. The patient is left intubated due to his altered mental status.