Prävention des postoperativen Delirs

Ziel einer erfolgreichen Prävention des postoperativen Delirs ist es, bei Patient*innen die Beeinträchtigung des funktionellen Status durch eine Operation so gering wie möglich zu halten. Dies kann durch allgemeine Präventionsmaßnahmen geschehen. Als zusätzlicher Ansatz eignen sich ergänzende individualisierte Maßnahmen. Geeignete Screening- und Assessment-Instrumente werden eingesetzt, um das individuelle Risikoprofil älterer Patient*innen zu erfassen und entsprechende präventive Maßnahmen einzuleiten.

Abstract

Postoperative delirium (POD) is an adverse but often preventable complication of surgery and surgery-related anaesthesia, and increasingly prevalent. This article provides an overview on non-pharmacological preventive measures, divided into individualized and non-individualized measures. Non-individualized measures, such as the most minimally invasive surgical procedure, avoidance of unnecessary fasting before surgery, and the most tolerable anaesthesia are used to minimize the risk of POD in all patients. Based on the results of preoperative screenings for risk factors such as frailty or cognitive impairment, individualized measures may encompass prehabilitation, treatment of specific risk factors, operation room companionship or cognitive, motor, and sensory stimulation as well as social support. This article additionally lists several examples of best practice approaches already implemented in German-speaking countries and websites for further readings.

Schlüsselwörter

Intensivstation - OP-Vorbereitung - postoperatives Delir - Prävention - Screening - Frailty - kognitive Beeinträchtigung - intensiv care unit

Keywords

OP preparation - prevention - postoperative delirium - screening - frailty - cognitive impairment

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