Postoperative delirium. Part 2: Detection, prevention and treatment

European Journal of Anaesthesiology

Volumn 28, Issue 10, 2011, Pages 723-732

  Steiner, Luzius A ^a  

^a LAUSANNE UNIVERSITY HOSPITAL   (Switzerland)

Author keywords

Antipsychotics; Benzodiazepines; Cholinesterase inhibitors; Delirium; Dexmedetomidine; Haloperidol; Postoperative complications

Indexed keywords

BENZODIAZEPINE DERIVATIVE; CHLORPROMAZINE; DEXMEDETOMIDINE; DONEPEZIL; HALOPERIDOL; KETAMINE; LORAZEPAM; OLANZAPINE; PLACEBO; QUETIAPINE; RISPERIDONE; RIVASTIGMINE;

ADD ON THERAPY; DELIRIUM; DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS; EXTRAPYRAMIDAL SYMPTOM; HUMAN; INTENSIVE CARE UNIT; INTERNATIONAL CLASSIFICATION OF DISEASES; PERIOPERATIVE PERIOD; POSTOPERATIVE COMPLICATION; PROPHYLAXIS; REVIEW; SCORING SYSTEM; SCREENING; SEDATION; SENSITIVITY AND SPECIFICITY; SLEEP DEPRIVATION;

AGED; ANESTHESIA; ANTIPSYCHOTIC AGENTS; BENZODIAZEPINES; CHOLINESTERASE INHIBITORS; CLINICAL TRIALS AS TOPIC; CONFUSION; DELIRIUM; DEXMEDETOMIDINE; HUMANS; INTENSIVE CARE; INTENSIVE CARE UNITS; POSTOPERATIVE COMPLICATIONS; RISK; SENSITIVITY AND SPECIFICITY;

EID: 80052836379     PISSN: 02650215     EISSN: 13652346     Source Type: Journal    
DOI: 10.1097/EJA.0b013e328349b7db     Document Type: Review

References (84)

1. Brown TM, Boyle MF. Delirium. BMJ 2002; 325:644-647.
2. Inouye SK, Viscoli CM, Horwitz RI, et al. A predictive model for delirium in hospitalized elderly medical patients based on admission characteristics. Ann Intern Med 1993; 119:474-481. (Pubitemid 23310108)
3. Kalisvaart KJ, Vreeswijk R, de Jonghe JF, et al. Risk factors and prediction of postoperative delirium in elderly hip-surgery patients: implementation and validation of a medical risk factor model. J Am Geriatr Soc 2006; 54:817- 822. (Pubitemid 44030205)
4. Marcantonio ER, Goldman L, Mangione CM, et al. A clinical prediction rule for delirium after elective noncardiac surgery. JAMA 1994; 271:134- 139. (Pubitemid 24020590)
5. Goldenberg G, Kiselev P, Bharathan T, et al. Predicting postoperative delirium in elderly patients undergoing surgery for hip fracture. Psychogeriatrics 2006; 6:43-48. (Pubitemid 43978492)
6. Rudolph JL, Jones RN, Levkoff SE, et al. Derivation and validation of a preoperative prediction rule for delirium after cardiac surgery. Circulation 2009; 119:229-236.
7. Freter SH, Dunbar MJ, MacLeod H, et al. Predicting postoperative delirium in elective orthopaedic patients: the Delirium Elderly At-Risk (DEAR) instrument. Age Ageing 2005; 34:169-171. (Pubitemid 40331100)
8. Inouye SK, Charpentier PA. Precipitating factors for delirium in hospitalized elderly persons. Predictive model and interrelationship with baseline vulnerability. JAMA 1996; 275:852-857. (Pubitemid 26087222)
9. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. Washington, DC: American Psychiatric Association; 2000.
10. World Health Organization: ICD-10 http://apps.who.int/classifications/ apps/icd/icd10online/. [Accessed 8 February 2011].
11. Adamis D, Sharma N, Whelan PJ, Macdonald AJ. Delirium scales: a review of current evidence. Aging Ment Health 2010; 14:543-555.
12. Wong CL, Holroyd-Leduc J, Simel DL, Straus SE. Does this patient have delirium? Value of bedside instruments. JAMA 2010; 304:779- 786.
13. Breitbart W, Rosenfeld B, Roth A, et al. The Memorial Delirium Assessment Scale. J Pain Symptom Manage 1997; 13:128-137. (Pubitemid 27172870)
14. Bergeron N, Dubois MJ, Dumont M, et al. Intensive Care Delirium Screening Checklist: evaluation of a new screening tool. Intensive Care Med 2001; 27:859-864. (Pubitemid 32480514)
15. Luetz A, Heymann A, Radtke FM, et al. Different assessment tools for intensive care unit delirium: which score to use? Crit Care Med 2010; 38:409-418.
16. Inouye SK, van Dyck CH, Alessi CA, et al. Clarifying confusion: the Confusion Assessment Method. A new method for detection of delirium. Ann Intern Med 1990; 113:941-948.
17. Trzepacz PT, Baker RW, Greenhouse J. A symptom rating scale for delirium. Psychiatry Res 1988; 23:89-97. (Pubitemid 18038426)
18. Trzepacz PT, Mittal D, Torres R, et al. Validation of the Delirium Rating Scale-revised-98: comparison with the Delirium Rating Scale and the cognitive test for delirium. J Neuropsychiatry Clin Neurosci 2001; 13:229-242. (Pubitemid 32499675)
19. Neelon VJ, Champagne MT, Carlson JR, Funk SG. The NEECHAM Confusion Scale: construction, validation, and clinical testing. Nurs Res 1996; 45:324-330. (Pubitemid 126433497)
20. Ely EW, Inouye SK, Bernard GR, et al. Delirium in mechanically ventilated patients: validity and reliability of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). JAMA 2001; 286:2703-2710. (Pubitemid 33135077)
21. Ely EW, Margolin R, Francis J, et al. Evaluation of delirium in critically ill patients: validation of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). Crit Care Med 2001; 29:1370-1379. (Pubitemid 32641799)
22. Gaudreau JD, Gagnon P, Harel F, et al. Fast, systematic, and continuous delirium assessment in hospitalized patients: the nursing delirium screening scale. J Pain Symptom Manage 2005; 29:368-375. (Pubitemid 40602517)
23. Ouimet S, Riker R, Bergeron N, et al. Subsyndromal delirium in the ICU: evidence for a disease spectrum. Intensive Care Med 2007; 33:1007- 1013. (Pubitemid 46835411)
24. Cole M, McCusker J, Dendukuri N, Han L. The prognostic significance of subsyndromal delirium in elderly medical inpatients. J Am Geriatr Soc 2003; 51:754-760. (Pubitemid 36693423)
25. Polderman KH. Screening methods for delirium: don't get confused!. Intensive Care Med 2007; 33:3-5. (Pubitemid 46115462)
26. Silverstein JH, Timberger M, Reich DL, Uysal S. Central nervous system dysfunction after noncardiac surgery and anesthesia in the elderly. Anesthesiology 2007; 106:622-628. (Pubitemid 46662227)
27. Vlajkovic GP, Sindjelic RP. Emergence delirium in children: many questions, few answers. Anesth Analg 2007; 104:84-91. (Pubitemid 46360426)
28. Lepouse C, Lautner CA, Liu L, et al. Emergence delirium in adults in the postanaesthesia care unit. Br J Anaesth 2006; 96:747-753. (Pubitemid 43786691)
29. Radtke FM, Franck M, Hagemann L, et al. Risk factors for inadequate emergence after anesthesia: emergence delirium and hypoactive emergence. Minerva Anestesiol 2010; 76:394-403.
30. Inouye SK, Bogardus ST Jr, Charpentier PA, et al. A multicomponent intervention to prevent delirium in hospitalized older patients. N Engl J Med 1999; 340:669-676. (Pubitemid 29110750)
31. Hjalmarson A, Goldstein S, Fagerberg B, et al. Effects of controlled-release metoprolol on total mortality, hospitalizations, and well being in patients with heart failure: the Metoprolol CR/XL Randomized Intervention Trial in congestive heart failure (MERIT-HF). MERIT-HF Study Group. JAMA 2000; 283:1295-1302. (Pubitemid 30129796)
32. Bogardus ST Jr, Desai MM, Williams CS, et al. The effects of a targeted multicomponent delirium intervention on postdischarge outcomes for hospitalized older adults. Am J Med 2003; 114:383-390. (Pubitemid 36513687)
33. Marcantonio ER, Flacker JM, Wright RJ, Resnick NM. Reducing delirium after hip fracture: a randomized trial. J Am Geriatr Soc 2001; 49:516-522. (Pubitemid 32525020)
34. Milisen K, Foreman MD, Abraham IL, et al. A nurse-led interdisciplinary intervention program for delirium in elderly hip-fracture patients. J Am Geriatr Soc 2001; 49:523-532. (Pubitemid 32525021)
35. Bjorkelund KB, Hommel A, Thorngren KG, et al. Reducing delirium in elderly patients with hip fracture: a multifactorial intervention study. Acta Anaesthesiol Scand 2010; 54:678-688.
36. Girard TD, Pandharipande PP, Ely EW. Delirium in the intensive care unit. Crit Care 2008; 12 (Suppl 3):S3.
37. Kalisvaart KJ, de Jonghe JF, Bogaards MJ, et al. Haloperidol prophylaxis for elderly hip-surgery patients at risk for delirium: a randomized placebo-controlled study. J Am Geriatr Soc 2005; 53:1658-1666. (Pubitemid 43109927)
38. Prakanrattana U, Prapaitrakool S. Efficacy of risperidone for prevention of postoperative delirium in cardiac surgery. Anaesth Intensive Care 2007; 35:714-719. (Pubitemid 47572095)
39. Larsen KA, Kelly SE, Stern TA, et al. Administration of olanzapine to prevent postoperative delirium in elderly joint-replacement patients: a randomized, controlled trial. Psychosomatics 2010; 51:409-418.
40. Liptzin B, Laki A, Garb JL, et al. Donepezil in the prevention and treatment of postsurgical delirium. Am J Geriatr Psychiatry 2005; 13:1100-1106. (Pubitemid 46638655)
41. Sampson EL, Raven PR, Ndhlovu PN, et al. A randomized, double-blind, placebo-controlled trial of donepezil hydrochloride (Aricept) for reducing the incidence of postoperative delirium after elective total hip replacement. Int J Geriatr Psychiatry 2007; 22:343-349. (Pubitemid 46680845)
42. Gamberini M, Bolliger D, Lurati Buse GA, et al. Rivastigmine for the prevention of postoperative delirium in elderly patients undergoing elective cardiac surgery: a randomized controlled trial. Crit Care Med 2009; 37:1762-1768.
43. Pandharipande PP, Pun BT, Herr DL, et al. Effect of sedation with dexmedetomidine vs lorazepam on acute brain dysfunction in mechanically ventilated patients: the MENDS randomized controlled trial. JAMA 2007; 298:2644-2653. (Pubitemid 350254956)
44. Pandharipande PP, Sanders RD, Girard TD, et al. Effect of dexmedetomidine versus lorazepam on outcome in patients with sepsis: an a priori-designed analysis of the MENDS randomized controlled trial. Crit Care 2010; 14:R38.
45. Ruokonen E, Parviainen I, Jakob SM, et al. Dexmedetomidine versus propofol/midazolam for long-term sedation during mechanical ventilation. Intensive Care Med 2009; 35:282-290.
46. Shehabi Y, Grant P, Wolfenden H, et al. Prevalence of delirium with dexmedetomidine compared with morphine based therapy after cardiac surgery: a randomized controlled trial (DEXmedetomidine COmpared to Morphine-DEXCOM Study). Anesthesiology 2009; 111:1075-1084.
47. Riker RR, Shehabi Y, Bokesch PM, et al. Dexmedetomidine vs midazolam for sedation of critically ill patients: a randomized trial. JAMA 2009; 301:489-499.
48. Maldonado JR, Wysong A, van der Starre PJ, et al. Dexmedetomidine and the reduction of postoperative delirium after cardiac surgery. Psychosomatics 2009; 50:206-217.
49. Tan JA, Ho KM. Use of dexmedetomidine as a sedative and analgesic agent in critically ill adult patients: a meta-analysis. Intensive Care Med 2010; 36:926-939.
50. Mantz J, Josserand J, Hamada S. Dexmedetomidine: new insights. Eur J Anaesthesiol 2011; 28:3-6.
51. Inouye SK. Delirium in older persons. N Engl J Med 2006; 354:1157- 1165.
52. Bourne RS, Mills GH. Melatonin: possible implications for the postoperative and critically ill patient. Intensive Care Med 2006; 32:371-379. (Pubitemid 43289645)
53. Aizawa K, Kanai T, Saikawa Y, et al. A novel approach to the prevention of postoperative delirium in the elderly after gastrointestinal surgery. Surg Today 2002; 32:310-314. (Pubitemid 34671262)
54. Leung JM, Sands LP, Rico M, et al. Pilot clinical trial of gabapentin to decrease postoperative delirium in older patients. Neurology 2006; 67:1251-1253. (Pubitemid 44563837)
55. Hudetz JA, Patterson KM, Iqbal Z, et al. Ketamine attenuates delirium after cardiac surgery with cardiopulmonary bypass. J Cardiothorac Vasc Anesth 2009; 23:651-657.
56. Siddiqi N, Stockdale R, Britton AM, Holmes J. Interventions for preventing delirium in hospitalised patients. Cochrane Database Syst Rev 2007:CD005563.
57. Bourne RS, Tahir TA, Borthwick M, Sampson EL. Drug treatment of delirium: past, present and future. J Psychosom Res 2008; 65:273-282.
58. Seitz DP, Gill SS, van Zyl LT. Antipsychotics in the treatment of delirium: a systematic review. J Clin Psychiatry 2007; 68:11-21. (Pubitemid 46220119)
59. Breitbart W, Marotta R, Platt MM, et al. A double-blind trial of haloperidol, chlorpromazine, and lorazepam in the treatment of delirium in hospitalized AIDS patients. Am J Psychiatry 1996; 153:231-237. (Pubitemid 26038965)
60. Menza MA, Murray GB, Holmes VF, Rafuls WA. Decreased extrapyramidal symptoms with intravenous haloperidol. J Clin Psychiatry 1987; 48:278- 280. (Pubitemid 17108405)
61. U.S. Food and Drug Administration: haloperidol (haldol, haldol decanoate, and haldol lactate). http://www.fda.gov/Safety/MedWatch/SafetyInformation/ SafetyAlertsforHumanMedicalProducts/ucm152676.htm [Accessed 23 November 2010].
62. Skrobik YK, Bergeron N, Dumont M, Gottfried SB. Olanzapine vs haloperidol: treating delirium in a critical care setting. Intensive Care Med 2004; 30:444-449. (Pubitemid 38375619)
63. Breitbart W, Tremblay A, Gibson C. An open trial of olanzapine for the treatment of delirium in hospitalized cancer patients. Psychosomatics 2002; 43:175-182. (Pubitemid 34522527)
64. Boettger S, Breitbart W. Atypical antipsychotics in the management of delirium: a review of the empirical literature. Palliat Support Care 2005; 3:227-237.
65. Kim SW, Yoo JA, Lee SY, et al. Risperidone versus olanzapine for the treatment of delirium. Hum Psychopharmacol 2010; 25:298-302.
66. Devlin JW, Roberts RJ, Fong JJ, et al. Efficacy and safety of quetiapine in critically ill patients with delirium: a prospective, multicenter, randomized, double-blind, placebo-controlled pilot study. Crit Care Med 2010; 38:419-427.
67. Lonergan E, Britton AM, Luxenberg J, Wyller T. Antipsychotics for delirium. Cochrane Database Syst Rev 2007:CD005594.
68. U.S. Food and Drug Administration: atypical antipsychotic drugs. http://www.fda.gov/Safety/MedWatch/SafetyInformation/ SafetyAlertsforHumanMedicalProducts/ucm150688.htm. [Accessed 23 November 2010].
69. Jacobi J, Fraser GL, Coursin DB, et al. Clinical practice guidelines for the sustained use of sedatives and analgesics in the critically ill adult. Crit Care Med 2002; 30:119-141. (Pubitemid 34112188)
70. Alici-Evcimen Y, Breitbart W. An update on the use of antipsychotics in the treatment of delirium. Palliat Support Care 2008; 6:177-182.
71. Han CS, Kim YK. A double-blind trial of risperidone and haloperidol for the treatment of delirium. Psychosomatics 2004; 45:297-301.
72. Sasaki Y, Matsuyama T, Inoue S, et al. A prospective, open-label, flexibledose study of quetiapine in the treatment of delirium. J Clin Psychiatry 2003; 64:1316-1321. (Pubitemid 37490236)
73. van EijkMM, Roes KC, Honing ML, et al. Effect of rivastigmine as an adjunct to usual care with haloperidol on duration of delirium and mortality in critically ill patients: a multicentre, double-blind, placebo-controlled randomised trial. Lancet 2010; 376:1829-1837.
74. Reade MC, O'Sullivan K, Bates S, et al. Dexmedetomidine vs. haloperidol in delirious, agitated, intubated patients: a randomised open-label trial. Crit Care 2009; 13:R75.
75. Pandharipande P, Shintani A, Peterson J, et al. Lorazepam is an independent risk factor for transitioning to delirium in intensive care unit patients. Anesthesiology 2006; 104:21-26.
76. Lonergan E, Luxenberg J, Areosa Sastre A. Benzodiazepines for delirium. Cochrane Database Syst Rev 2009:CD006379.
77. DOCUMED SA. Medikamenten Kompendium der Schweiz. Basel: DOCUMEND SA; 2011. pp. 4944-4946.
78. DeBellis R, Smith BS, Choi S, Malloy M. Management of delirium tremens. J Intensive Care Med 2005; 20:164-173. (Pubitemid 43086469)
79. Mayo-Smith MF, Beecher LH, Fischer TL, et al. Management of alcohol withdrawal delirium. An evidence-based practice guideline. Arch Intern Med 2004; 164:1405-1412. (Pubitemid 38937851)
80. Hodges B, Mazur JE. Intravenous ethanol for the treatment of alcohol withdrawal syndrome in critically ill patients. Pharmacotherapy 2004; 24:1578-1585. (Pubitemid 39426353)
81. Witlox J, Eurelings LS, de Jonghe JF, et al. Delirium in elderly patients and the risk of postdischarge mortality, institutionalization, and dementia: a meta-analysis. JAMA 2010; 304:443-451.
82. Breitbart W, Gibson C, Tremblay A. The delirium experience: delirium recall and delirium-related distress in hospitalized patients with cancer, their spouses/caregivers, and their nurses. Psychosomatics 2002; 43:183-194. (Pubitemid 34522528)
83. van Gool WA, van de Beek D, Eikelenboom P. Systemic infection and delirium: when cytokines and acetylcholine collide. Lancet 2010; 375:773-775.
84. National Clinical Guideline Center: delirium: diagnosis, prevention and management. http://www.nice.org.uk/nicemedia/live/13060/49908/49908.pdf. [Accessed 8 February 2011].