Delirium After TAVR
| Autor: | Marleen H. van Wely, Ronak Delewi, Peter Pickkers, Niels van Royen, Marc A. Brouwer, Marcel G. M. Olde Rikkert, Jan Baan, Max J.P. Rooijakkers, Wim J. Morshuis, Mark van den Boogaard, Kees van der Wulp, Nicolas M. Van Mieghem |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Sleep hygiene business.industry medicine.medical_treatment Psychological intervention Context (language use) 030204 cardiovascular system & hematology medicine.disease 03 medical and health sciences 0302 clinical medicine Valve replacement Orientation (mental) Carotid artery disease Medicine Delirium 030212 general & internal medicine medicine.symptom Cardiology and Cardiovascular Medicine business Intensive care medicine Risk assessment |
| Zdroj: | JACC: Cardiovascular Interventions. 13:2453-2466 |
| ISSN: | 1936-8798 |
| DOI: | 10.1016/j.jcin.2020.07.044 |
| Popis: | Patients who undergo transcatheter aortic valve replacement often are frail and elderly. Delirium is a frequently observed complication, associated with impaired recovery, prolonged hospital stay, and mortality. In different hospital settings, interventions that reduced the incidence of delirium resulted in improved clinical outcome and reduced costs. In that context, prevention, early recognition, and timely interventions could be the next step toward better outcomes of transcatheter aortic valve replacement. This review is focused on awareness and recognition of delirium, including predisposing "vulnerability" factors (such as cognitive impairment and carotid artery disease) and "trigger" factors (such as anesthesia, hemodynamic imbalance, and complications). For prevention and treatment, clinicians should focus on sleep hygiene, orientation, pain management, and early mobilization. In case of delirium, a thorough search and treatment of trigger factors is warranted. Future studies should focus on risk assessment, preventive and therapeutic interventions, and their potential benefit in terms of costs and clinical outcomes. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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