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Review
. 2023 Feb;94(2):93-98.
doi: 10.1007/s00115-022-01398-9. Epub 2022 Oct 21.

[Delirium in the context of intensive care medicine-Part 1: epidemiology, definitions, pathophysiology]

[Article in German]
R Haußmann  1 , A Postler  2 , M Mirus  3
Affiliations
Review

[Delirium in the context of intensive care medicine-Part 1: epidemiology, definitions, pathophysiology]

[Article in German]
R Haußmann et al. Nervenarzt. 2023 Feb.

Abstract
in English, German

The prevalence of delirium syndromes is high, they are often underdiagnosed and therefore medically as well as economically highly relevant syndromes due to the long-term sequelae. In the majority of cases, delirium has a multifactorial etiology, which is why a comprehensive search for the cause is of highest priority. Surgery, administration of potentially proinflammatory drugs as well as the intensive care environment, including the underlying disease and drugs used, represent relevant etiological factors. Pathophysiology and psychopathology are complex and vary depending on the etiological factors present. Prominent impairment of attention and consciousness are central symptoms of delirium allowing the differentiation from important differential diagnoses, such as encephalopathy, depression, psychosis and dementia.

Die Prävalenz deliranter Syndrome ist hoch, sie sind oft unterdiagnostiziert und damit von immenser medizinischer und gesundheitsökonomischer Bedeutung, was unter anderem aus den Folgen des Delirs resultiert. Delirien sind mehrheitlich multifaktorieller Genese, weshalb einer umfassenden Fokussuche des Delirs eine hohe Bedeutung zukommt. Relevante ätiologische Faktoren im intensivmedizinischen Bereich sind Operationen, potenziell proinflammatorisch wirksame Narkotika sowie die delirogene intensivmedizinische Umgebung inklusive Grunderkrankung und verwendeter Medikamente. Pathophysiologie und Psychopathologie sind komplex und variabel in Abhängigkeit der vorliegenden ätiologischen Faktoren. Zentral in der Abgrenzung relevanter Differenzialdiagnosen wie Enzephalopathien, Altersdepression, Psychose und Demenzerkrankungen sind ausgeprägte Aufmerksamkeits- und Bewusstseinsstörungen, die Leitsymptome deliranter Syndrome darstellen.

Keywords: Acute confusional states; Delirium; Encephalopathy; Intensive care medicine; Psychotic symptom.

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References

Literatur

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