Ursachen und Therapie des Delirs

Abstract

Delirium is a potentially life-threating acute disease accompanied by a mortality up to 30 % of all affected patients. It occurs more frequently in older patients ≥ 65 years. Delirium is defined as acute onset of disturbances in attention, awareness and cognition that develops within a short period of time and fluctuates in severity. It can be subdivided in hyperactive, hypoactive and a mixed type. The hypoactive type occurs more frequently in geriatric patients and has the highest mortality of all types. Differential diagnosis of delirium include stroke, central nervous system infection, metabolic diseases, disturbances in electrolytes as well as Wernicke encephalopathy and psychiatric diseases. Treatment should be initiated rapidly and includes non-pharmacological interventions and specific pharmacological treatments. The review summarizes diagnosis and clinical management of patients with delirium.

Das Delir ist eine potenziell lebensbedrohliche Erkrankung, die durch vielfältige Ursachen ab dem 65. Lebensjahr auftreten kann und durch die steigende Alterung der Bevölkerung zunimmt. Bei jüngeren Patienten überwiegt als Ursache der Entzug von Alkohol oder psychotropen Substanzen. Der Beitrag soll die klinischen Zeichen eines Delirs, die Pathophysiologie und Ätiologie, notwendige diagnostische Schritte und die Therapie zusammenfassen.

Schlüsselwörter

Delir - Delir Subtypen - hypoaktives Delir - hyperaktives Delir - postoperatives Delir

Key words

delirium - delirium subtypes - hypoactive delirium - hyperactive delirium - postoperative delirium

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