加護單位重症患者譫妄的生理病理機轉與評估

Pathophysiology and Assessment of Delirium in Patients Who are Critically Ill in the Intensive Care Unit

譫妄是成人加護單位病患常見的臨床問題。近年有關譫妄的診療與照護指引陸續發表，期能更有效幫助臨床照護團隊解決成人加護病人譫妄的問題。本文除闡述譫妄在重症病患的盛行率及在加護單位常見的譫妄類型，並綜合最近發表的文章說明其在急重症病患的生病理機轉、譫妄危險因子的預測評估模式、國內外常用兩種譫妄行為篩檢評估工具以及更客觀的生理性評估，以期望能提高護理人員對成人加護單位譫妄的認識。

Delirium is a common clinical problem among adult patients receiving care in intensive care units (ICU). In recent years, several guidelines for the diagnosis, treatments, and care of ICU adult patient's delirium have been published with the objective of assisting clinical care teams to address the issue of delirium more effectively. In order to improve the understanding of delirium among ICU nursing staffs, the prevalence and common types of delirium in adult ICU settings are introduced in this article. In addition, recently published articles are synthesized to demonstrate the pathophysiological mechanisms of delirium, introduce the predictive assessment model of risk factors and two commonly used behavioral screening assessment tools, and describe the approach to conducting physiological assessments in delirium patients with acute and critical illnesses.