DELIRIUM DISEASE DEFINITION, PREVENTION, AND TREATMENT

DELIRIUM DISEASE DEFINITION, PREVENTION, AND TREATMENT

Understanding Delirium Disease – Delirium is a fairly common condition, especially in elderly patients in the hospital. Delirium is a condition of decreased consciousness with symptoms that are not typical. This disorder is acute and fluctuating.

The prevalence of delirium events is in the range of 23% for hospitalization. Delirium has a bad effect because it not only extends the length of stay and decreases the quality of life of the sufferer, but delirium also increases the mortality rate of the patient.

delirium

Diagnosis of Delirium Disease

To be able to know the diagnosis of delirium, it can be done through careful observation of the patient’s clinical appearance. Therefore a real understanding of the delirium clinical picture is required. Generally, patients come with complaints of reduced attention or attention, psychomotor disorders, sleep cycle disorders and occur in a short time.

Diagnosis of delirium requires five criteria, namely:

Disturbance of consciousness, a decrease in the clarity of awareness of the environment, with decreased ability to focus, maintain or change attention.

The disorder develops in a short period (usually several hours to days) and tends to fluctuate in its course.

Cognitive changes (such as memory deficits, disorientation, language disorders) or the development of perceptual disorders that can not be incorporated into dementia conditions.

Disorders of the first (consciousness) and third (cognitive impairment) criteria are not caused by other existing, established or developing neurocognitive disorders and do not arise in conditions of severe depression, such as coma.

Findings of evidence from a history, physical examination, or laboratory indicating a disorder resulting from direct physiological consequences of a general medical condition, intoxication or cessation of substance (such as drug abuse or treatment), exposure to toxins, or due to multiple etiologies.

Symptoms of Illness Delirium

The main symptom of delirium is the presence of global cognitive disorders characterized by short-term memory disorders, perceptual disorders, or impaired thought processes.

Also, delirium can also show psychomotor views such as:

  • Delirium is hypoactive
    A total of 25% will have a clinical appearance of hypoactive delirium. In this type of delirium, the patient will be calm and withdraw. Patients will tend to fall asleep and have a slow response.
  • Delirium is hyperactive.
    Patients will show a rowdy look, anxiety, and speech raved. Also, patients also often experience hallucinations.
  • Delirium blend
    Patients present a clinical picture of both hyperactive and hypoactive.

Treatment of Disease Delirium

The main step is to assess all possible causes, provide supportive support, and prevent complications. Keep the condition of the patient to avoid an accident during the treatment, because the patient is in the phase of consciousness decline. Treatment of the underlying problem is necessary – allow infection, decreased blood sugar, defecation disorders or urination, and immobilization.

Cause of Disease Delirium

Delirium is a complex, multifactorial phenomenon, and affects the various parts of the central nervous system. One of the mechanisms of delirium is neurotransmitter deficiency. Also, hypoglycemia and hypoxia also play a role in the occurrence of delirium. Acetylcholine deficiency can interfere with the transmission of neurotransmitters in the brain.

Also, delirium can also occur as a result of the cessation of substances such as alcohol, benzodiazepines, or nicotine. Predisposing factors of a person experiencing delirium are:

  • Very old age
  • Mild cognitive impairment – dementia
  • Impaired functionality on the move
  • Sensory Disorders
  • Frailty elderly
  • Drugs (ranitidine, cimetidine, psychotropic ciprofloxacin)
  • Polypharmacy

The trigger factors that are often encountered include:

  • Pneumonia
  • Urinary tract infection
  • Hyponatremia
  • Dehydration
  • Hypoglycemia
  • CVD
  • Environmental change (displacement)

Delirium is an abnormal mental state, not a disease; with some symptoms suggesting a decline in mental function. Various conditions or diseases (from mild dehydration to drug intoxication or infection that can be fatal), can cause delirium, this is most common in elderly and people whose brains have been impaired, including sick people, people taking drugs which causes changes in mind or behavior and people with dementia.

The cause of delirium:

  • Alkohol, drugs and toxic materialsAlcohol, drugs and toxic materials
  • Toxic effects of treatment
  • Electrolytes, salts, and minerals (e.g., calcium, sodium or magnesium) are not normal due to treatment, dehydration or certain diseases
  • Acute infection with fever
  • Normal pressure hydrocephalus, a state where the fluid that replaces the brain is not properly absorbed and suppresses the brain
  • Hematoma subdural, the collection of blood under the skull that can suppress the brain.
  • Meningitis, encephalitis, syphilis (infectious diseases that attack the brain)
  • The deficiency of thiamine and vitamin B12
  • Hypothyroidism and hypothyroidism
  • Brain tumors (some of which sometimes cause confusion and memory disorders)
  • Broken bone and long bones
  • Bad heart or lung function and cause low levels of oxygen or high levels of carbon dioxide in the blood
  • Stroke.

DELIRIUM

Prevention of Disease Delirium

Prevention of delirium can be done by avoiding various risk factors that increase the risk of delirium. Older people (above 60 years old) have a higher risk of developing delirium.

Avoid using drugs that increase the risk of delirium, such as ranitidine, digoxin, ciprofloxacin, codeine, amitriptyline (antidepressants), a benzodiazepine. Also, the involvement of different disciplines is needed to solve the problem of delirium sufferers.

Delirium prevention can be done by avoiding various risk factors that increase the risk of delirium. Older people (above 60 years old) have a higher risk of developing delirium.

Avoid using drugs that increase the risk of delirium, such as ranitidine, digoxin, ciprofloxacin, codeine, amitriptyline (antidepressants), a benzodiazepine. Also, the involvement of different disciplines is needed to solve the problem of delirium sufferers.