Update of the European Society of Anaesthesiology and Intensive Care Medicine evidence-based and consensus-based guideline on postoperative delirium in adult patients

César Aldecoa, Gabriella Bettelli, Federico Bilotta, Robert D Sanders, Paola Aceto, Riccardo Audisio, Antonio Cherubini, Colm Cunningham, Wojciech Dabrowski, Ali Forookhi, Nicola Gitti, Kaisa Immonen, Henrik Kehlet, Susanne Koch, Katarzyna Kotfis, Nicola Latronico, Alasdair M J MacLullich, Lior Mevorach, Anika Mueller, Bruno NeunerSimone Piva, Finn Radtke, Annika Reintam Blaser, Stefania Renzi, Stefano Romagnoli, Maria Schubert, Arjen J C Slooter, Concezione Tommasino, Lisa Vasiljewa, Bjoern Weiss, Fatima Yuerek, Claudia D Spies

Onderzoeksoutput: Articlepeer review

Samenvatting

Postoperative delirium (POD) remains a common, dangerous and resource-consuming adverse event but is often preventable. The whole peri-operative team can play a key role in its management. This update to the 2017 ESAIC Guideline on the prevention of POD is evidence-based and consensus-based and considers the literature between 01 April 2015, and 28 February 2022. The search terms of the broad literature search were identical to those used in the first version of the guideline published in 2017. POD was defined in accordance with the DSM-5 criteria. POD had to be measured with a validated POD screening tool, at least once per day for at least 3 days starting in the recovery room or postanaesthesia care unit on the day of surgery or, at latest, on postoperative day 1. Recent literature confirmed the pathogenic role of surgery-induced inflammation, and this concept reinforces the positive role of multicomponent strategies aimed to reduce the surgical stress response. Although some putative precipitating risk factors are not modifiable (length of surgery, surgical site), others (such as depth of anaesthesia, appropriate analgesia and haemodynamic stability) are under the control of the anaesthesiologists. Multicomponent preoperative, intra-operative and postoperative preventive measures showed potential to reduce the incidence and duration of POD, confirming the pivotal role of a comprehensive and team-based approach to improve patients' clinical and functional status.

Originele taal-2English
Pagina's (van-tot)81-108
Aantal pagina's28
TijdschriftEuropean Journal of Anaesthesiology
Volume41
Nummer van het tijdschrift2
DOI's
StatusPublished - 1 feb 2024

Bibliografische nota

Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the European Society of Anaesthesiology and Intensive Care.

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