Nicht pharmakologische und pharmakologische Therapie des Delirs

Abstract

The therapeutic management of delirium is based on two major columns. The cornerstone of therapy is the non-pharmacological intervention using a multifactorial approach including early mobilization, reorientation, improvement of cerebral and cognitive activity and the consequent establishment of adequate wake-/sleep cycles. Evidence for specific pharmacotherapy in delirium is currently rare, for both delirium prophylaxis as well as for definitive therapy of clinically apparent delirium. However, in clinical routine several substances are commonly used for the management of delirium particularly in a symptom-oriented choice. Moreover, regarding delirium prophylaxis the choice of sedativum has an important clinical impact on the incidence of delirium.

Das therapeutische Management des Delirs basiert auf 2 wesentlichen Säulen: der nicht pharmakologischen Intervention und der spezifischen Pharmakotherapie. Dabei gilt die nicht pharmakologische Therapie als zentraler und primärer Baustein im Behandlungskonzept des Delirs. Dieser Beitrag widmet sich dem multifaktoriellen nicht pharmakologischen Therapieansatz und erläutert auch, welche pharmakologischen Substanzen ggf. eingesetzt werden können.

Schlüsselwörter

Delir - Therapie - Pharmakotherapie - Sedierung - nicht pharmakologische Intervention

Key words

delirium - sedation - critical care - protocols - guidelines

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