Wie können postoperativ ein Delir und eine neurokognitive Störung verhindert werden?

Zusammenfassung

Ein postoperatives Delir (POD) geht mit einem hohen Leidensdruck für die betroffenen Patienten und ihre Angehörigen und einem großen Mehraufwand für das klinische Personal einher. Darüber hinaus belasten die entstehenden Kosten erheblich das Gesundheitssystem. Der Beitrag beleuchtet die Optionen der Risikoreduktion in der postoperativen Versorgung, um ein POD und eine postoperative neurokognitive Störung zu vermeiden.

Abstract

Postoperative delirium (POD) is a common and serious complication after surgery. It is associated with increased morbidity and mortality as well as neurocognitive disorder and associated loss of autonomy and increased need for care. As professionals, it is our duty to treat our patients in a holistic individual concept with the aim to reintegrate our patients into their home and social environment afterwards. In addition to preoperative and intraoperative interventions, postoperative prevention is of particular importance. This article focuses on non-pharmacological prevention strategies to avoid postoperative delirium and neurocognitive disorder in postoperative inpatient care. It is based on the “Evidence-based and consensus-based guideline on postoperative delirium”. Thus, risk factors are addressed and non-pharmacological strategies are presented, which include reorientation, mobilization and nutritional support. Interprofessional cooperation plays just as important a role as the implementation of the listed preventive measures. Finally, the modified Hospital Elder Life Program is presented, which presents and applies preventive measures as a system-oriented and interdisciplinary concept, which “prevents functional decline and allows older adults to return home at the maximal level of independence”. From our point of view, the training of a professional delirium team is a future-oriented complementary measure in the treatment concept of Perioperative Neurocognitive Disorders (PND), which finds its justification as an interface in the treatment of high-risk patients.

Schlüsselwörter

postoperatives Delir - Delir-Screening - HELP - Delirteam - Prävention

Key words

postoperative delirium - delirium screening - HELP - delirium team - prevention

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