Sema TURAN, Şerife GÖKBULUT, Dilek KAZANCI, Demet BÖLÜKBAŞI, Gönül ERDAL, Özcan ERDEMLİ

Yoğun Bakımda Deliryum Tedavisinde Dexmedetomidin Kullanımı: Olgu Sunumu

Yoğun bakımda postoperatif kognitif disfonsiyon ve deliryumun görülme sıklığı %30-80’dir ve deliryumun mortalite ve morbiditeyi belirgin olarak arttırdığı bilinmektedir. Tedavisinde non-farmakolojik yöntemlerin yanı sıra farmakolojik tedavilerde kullanılmaktadır. Son dönem yayınlarda deliryum tedavisinde deksmedetomidin kullanımı önerilmektedir. Bu yazıda yoğun bakımda hipoaktif deliryum tablosu olan hastada deksmedetomidin tedavisinin etkisini sunmayı amaçladık

The Dexmedetomidin Using In Treatment of Delirium In The Intensive Care Unit: Case Report

Postoperative cognitive dysfunction and delirium incidence is between %30 and %80 and delirium is known to significantly increased mortality and morbidity. Beside non-pharmacological methods in treatment of delirium, pharmacological method could be applied. In recent literature, dexmedetomidin is recommended in delirium treatment. In this report, we aimed to evaluate the effect of dexmedetomidin treatment in patient with hypoactive delirium in intensive care unit

Keywords:

Intensive care unit, Delirium, Dexmedetomidine,

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Pandharipande P, Cotton BA, Shintani A, Thompson J, Pun BT, Morris JA Jr, Dittus R, Ely EW. Prevalence and risk factors for development of delirium in surgical and trauma intensive care unit patients. J Trauma 2008, 65:34-41.

Devlin JW, Bhat S, Roberts RJ, Skrobik Y. Current perceptions and practices surrounding the recognition and treatment of delirium in the intensive care unit: a survey of 250 critical care pharmacists from eight States. Ann Pharmacother 2011 Oct; 45(10):1217-29.

Ely EW, Shintani A, Truman B, Speroff T, Gordon SM, Harrell FE Jr, Inouye SK, Bernard GR, Dittus RS. Delirium as a predictor of mortality in mechanically ventilated patients in the intensive care unit. JAMA 2004, 291:1753-62.

Riker RR, Picard JT, Fraser GL. Prospective evaluation of the Sedation- Agitation Scale for adult critically ill patients. Crit Care Med 1999, 27:1325-9.

Mountain BW, Smithson L, Cramolini M, Wyatt TH, Newman M. Dexmedetomidine as a pediatric anesthetic premedication to reduce anxiety and to deter emergence delirium. AANA J 2011 Jun; 79(3):219-24.

Pichot C, Ghignone M, Quintin L. Dexmedetomidine and clonidine: from second-to-first-line sedative agents in the critical care setting? J Intensive Care Med 2011 Apr 27. [Epub ahead of print] (doi: 10.1177/0885066610396815)

Girard TD, Pandharipande PP, Carson SS, Schmidt GA, Wright PE, Canonico AE, et al. MIND Trial Investigators. Feasibility, efficacy, and safety of antipsychotics for intensive care unit delirium: the MIND randomized, placebo-controlled trial. Crit Care Med 2010 Feb; 38(2):428-37.

Lacasse H, Perreault MM, Williamson DR. Systematic review of antipsychotics for the treatment of hospital-associated delirium in medically or surgically ill patients. Ann Pharmacother 2006 Nov; 40(11):1966-73.

Pelland C, Trudel JF. Atypical antipsychotic efficacy and safety in managing delirium: a systematic review and critical analysis. Psychol Neuropsychiatr Vieil 2009 Jun; 7(2):109-19.

Wan LJ, Huang QQ, Yue JX, Lin L, Li SH. Comparison of sedative effect of dexmedetomidine and midazolam for post-operative patients undergoing mechanical ventilation in surgical intensive care unit. Zhongguo Wei Zhong Bing Ji Jiu Yi Xue 2011 Sep; 23(9):543-6.

Yapici N, Coruh T, Kehlibar T, Yapici F, Tarhan A, Can Y, Ozler A, Aykac Z. Dexmedetomidine in cardiac surgery patients who fail extubation and present with a delirium state. Heart Surg Forum 2011 Apr; 14(2):E93-8.

Reade MC, O‘Sullivan K, Bates S, Goldsmith D, Ainslie WR, Bellomo R. Dexmedetomidine vs. haloperidol in delirious, agitated, intubated patients: a randomised open-label trial. Crit Care 2009; 13(3):R75, p:1-10.

Guenther U, Radtke FM. Delirium in the postanaesthesia period. Curr Opin Anaesthesiol 2011 Oct 3. [Epub ahead of print] (doi: 10.1097/ ACO.0b013e32834c7b44)