Progress in the study of secondary delirium in ICU patients after cardiac surgery
Objective Our population is increasingly ageing,the incidence of cardiovascular diseases has shown a rising trend year by year,more and more patients need to receive the heart surgical treatments.Delirium is a common clinical syndrome with severe psychiatric symptoms in postoperative cardiac intensive care unit(ICU)patients.Secondary delirium in postoperative cardiac ICU patients prolongs the duration of mechanical ventilation,leads to long-term cognitive deficits,prolongs hospitalization,increases the mortality rate,affects the prognosis of patients.At present,the pathophysiologic mechanisms underlying the development of delirium are still unclear,but a number of studies have revealed the factors influencing secondary delirium in postoperative cardiac ICU patients.These factors include high-risk factors that already existed preoperatively,such as advanced age,hypertension,diabetes mellitus,and atrial fibrillation;intraoperative altered influencing factors,such as cardiac dysfunction,prolonged duration of surgery and extracorporeal circulation,and microembolism;and postoperative influencing factors,such as special environmental stimuli in the ICU,electrolyte disorders in the body,and bad pain control.This article summarizes the influencing factors,diagnostic and assessment tools,preventive and nursing measures of secondary delirium in ICU patients after cardiac surgery,hoping that clinical medical staff can effectively identify and manage the influencing factors that induce delirium by mastering the tools for diagnosing and assessing delirium,and take pharmacological or non-pharmacological preventive measures based on conventional treatment and nursing care,and implement the ABCDEF cluster nursing program(A:Assessment,prevention and management of pain.B:Daily spontaneous awakening test and autonomous breathing test.C:Choice of analgesic and sedative.D:Assessment,prevention and management of delirium.E:Early activity and exercise.F:Participation of family members),to prevent the occurrence of delirium in post-cardiac surgery ICU patients,to reduce the duration of delirium,and to improve the prognosis of patients.
Cardiac surgeryIntensive care unitDeliriumPostoperative careResearch progress
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