Title: Delirium in the Critically Ill
题目：危重病人的谵妄表现
Author 作者: Michael Winters

Delirium has been shown to be an independent predictor of mortality and can occur in up to 75% of critically ill patients.
已有证据证实，谵妄是一个预测增加死亡率的独立危险因素，可出现在75％的危重病人身上。
Whether preventing or treating delirium in the critically ill patient, consider the following:
预防或治疗谵妄的危重病人时，要考虑如下情况：
Minimize the use of anticholinergic medications (i.e. diphenhydramine, chlorpromazine)
限制抗胆碱能药物的使用（如苯海拉明，氯丙嗪）
Ensure pain is adequately controlled (avoid meperidine and tramadol)
有效控制疼痛（避免杜冷丁，曲马多）
Be careful with sedative medications; consider bolus dosing and daily interruption of continuous infusions
小心使用镇静剂，可用静脉推注，对持续注射的药物每天要有停止时间
Additional measures to treat delirious patients include reducing sensory deprivation, promoting normal sleep-wake cycles, early physical rehabilitation, and treating psychosis.
治疗谵妄病人的其它办法包括，增加感觉刺激，建立正常的睡眠规律，早期物理康复，和治疗精神紊乱。

References 参考文献

Bienvenu OJ, Neufeld KJ, Needham DM. Treatment of four psychiatric emergencies in the intensive care unit. Crit Care Med 2012; 40:2662-2670.