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Delirium

Delirium. Delirium. Disturbances of consciousness A change in cognition Developing over a short period of time. Delirium Epidemiology. 5-15% in hospitalized patient 20-30% in ICU and CCU 40-50% after surgery of hip fractures 90% in postcardiotomy patients 20% in severe burns

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Delirium

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  1. Delirium

  2. Delirium • Disturbances of consciousness • A change in cognition • Developing over a short period of time

  3. DeliriumEpidemiology • 5-15% in hospitalized patient • 20-30% in ICU and CCU • 40-50% after surgery of hip fractures • 90% in postcardiotomy patients • 20% in severe burns • 80% in terminally ill patients

  4. DeliriumRisk Factors • Advanced age • Brain damage • History of delirium • Alcohol dependence • Diabetes • Cancer • Sensory impairment • Malnutrition

  5. Causes of delirium • CNS Disease • Drugs • Metabolic insufficiency • Alcohol withdrawal syndrome • Systemic infection • Deficiency disease • Electrolyte imbalance • Postoperative states • trauma

  6. DeliriumEtiology • Decreased acetylcholine activity in brain • Decreased oxidative metabolism • Increased NE, dopamine ,glutamate in brain • Abnormality of endocrine system

  7. symptoms • Consciousness -Attention -Orientation • Behavior • Thinking • Mood • Perception • Memory

  8. Differential diagnosis • Psychosis • Dementia • Pseudodementia

  9. CBCdiff TFT Blood chemistries: Electrolytes Renal Hepatic glucose Urinanalysis ECG CXR EEG HIVtest Additional tests CTscan LP….. DeliriumLaboratory work up

  10. DeliriumTreatment • Treating of underlying cause • Physical ,sensory and environmental support • Treatment of psychosis • Treatment of insomnia

  11. Delirium • Course • prognosis

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