[Delirium Prevention]

Rev Colomb Psiquiatr. 2016 Jan-Mar;45(1):37-45. doi: 10.1016/j.rcp.2015.06.005. Epub 2015 Sep 19.
[Article in Spanish]

Abstract

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.

Keywords: Aetiology; Delirium; Etiología; Factores de riesgo; Prevención primaria; Primary prevention; Risk factor; Therapeutics; Tratamiento.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Antipsychotic Agents / therapeutic use*
  • Critical Care
  • Delirium / epidemiology
  • Delirium / etiology
  • Delirium / prevention & control*
  • Dexmedetomidine / therapeutic use*
  • Humans
  • Precipitating Factors
  • Prognosis
  • Risk Factors

Substances

  • Antipsychotic Agents
  • Dexmedetomidine