Covid 19 Pandemisi ve Deliryum

Yıl 2022, Cilt: 31 Sayı: 3, 137 - 150, 30.09.2022

Ebru Biricik , Yasemin Güneş

https://doi.org/10.17827/aktd.1055896

Öz

Covid 19 pandemisi ciddi akut solunum ve organ yetmezlikleri ile seyreden mortalite ile sonuçlanabilen bir salgın olarak tarihe geçmektedir. Covid 19 enfeksiyonuna yakalanan bu hastalarda ciddi bir izolasyonun yanı sıra medikal tedavi de uygulanması hatta mekanik ventilatör ihtiyacı da doğmaktadır. Hastalar Covid 19 enfeksiyonunun santral sinir sistemine yapmış olduğu etkilerden dolayı da deliryum tablosuna girebilmektedir. Deliryumun önlenmesi ve tedavisi hem ortamın hasta açısından düzenlenmesi hem de medikal tedavinin uygulanması ile sağlanabilir. Bu hastalarda oluşan deliryuma yaklaşım multidisipliner olmalı ve öncelik deliryumun önlenmesi amaçlanmalıdır. Çünkü gelişen deliryum ile hastanede kalış süresi, sekonder enfeksiyonlar ve mortalite artabilmektedir. Bu derlemenin amacı Covid 19 salgını ile deliryumun önlenmesi ve yönetimini yorumlamaktır.

Anahtar Kelimeler

covid 19 pandemisi, deliryum, yoğun bakım

Kaynakça

• Referans1. Girard TD, Thompson JL, Pandharipande PP, Brummel NE, Jackson JC, Patel MB et al. Clinical phenotypes of delirium during critical illness and severity of subsequent long-term cognitive impairment: a prospective cohort study. Lancet Respir Med. 2018; 6: 213–22.
• Referans2. Pandharipande PP, Girard TD, Jackson JC, Morandi A, Thompson JL, Pun BT, et al. BRAIN-ICU Study Investigators. Long-term cognitive impairment after critical illness. N Engl J Med. 2013; 369: 1306–16.
• Referans3. World Health Organization (WHO), Weekly operational update Covid 19. Available from: http://www.who.int. Accessed: 10 December 2021
• Referans4. Asadi-Pooya AA, Simani L. Central nervous system manifestations of COVID-19: a systematic review. J Neurol Sci. 2020; 413: 116832.
• Referans5. Kotfis K, Marra A, Ely EW. ICU delirium – a diagnostic and therapeutic challenge in the intensive care unit. Anaesthesiol Intensive Ther. 2018; 50: 160–7.
• Referans6. Mao L, Wang M, Chen S, Hu Y, Chen S, He Q et al. Neurological manifestations of hospitalized patients with COVID-19 in Wuhan, China: a retrospective case series study. medRxiv JAMA Neurol. 2020; 77: 683-90.
• Referans7. Helms J, Kremer S, Merdji H, Schenck M, Severac F, Clere-Jehl R et al. Delirium and encephalopathy in severe COVID-19: a cohort analysis of ICU patients. Crit Care. 2020; 24: 491.
• Referans8. Helms J, Kremer S, Merdji H, Clere-Jehl R, Schenck M, Kummerlen C. et al. Neurologic Features in Severe SARS-CoV-2 Infection. N Engl J Med. 2020; 382:2268-70.
• Referans9. Garcez FB, Aliberti MJR, Poco PCE, Hiratsuka M, Takahashi SF, Coelho VA et al. Delirium and adverse outcomes in hospitalized patients with COVID-19. J Am Geriatr Soc. 2020; 68: 2440–46.
• Referans10. Mattace-Raso F, Polinder-Bos H, Oosterwijk B, van Bruchem-Visser R, Goudzwaard J, Oudshoorn C, Ziere G et al. Delirium: A Frequent Manifestation in COVID-19 Older Patients. Clin Interv Aging. 2020;15: 2245-7.
• Referans11. Ely EW, Shintani A, Truman B, Speroff T, Gordon SM, Harrell FE Jr et al. Delirium as a predictor of mortality in mechanically ventilated patients in the intensive care unit. JAMA. 2004; 291: 1753–62.
• Referans12. Kapp CM, Zaeh S, Niedermeyer S, Punjabi NM, Siddharthan T, Damarla M. The use of analgesia and sedation in mechanically ventilated patients with COVID-19 ARDS. Anesth Analg. 2020; 131: 198–200.
• Referans13. Pun BT, Badenes R, La Calle GH, Orun OM, Chen W, Raman R et al. Pratik P Pandharipande, for the COVID-19 Intensive Care International Study Group† Prevalence and risk factors for delirium in critically ill patients with COVID-19 (COVID-D): a multicentre cohort Study. Lancet Respir Med. 2021; 9: 239-50.
• Referans14. Dorota Ozga, Sabina Krupa, Paweł Witt, Wioletta M ˛edrzycka-D ˛abrowska, Nursing Interventions to Prevent Delirium in Critically Ill Patients in the Intensive Care Unit during the COVID19 Pandemic—Narrative Overview. Healthcare. 2020; 8: 578.
• Referans15. Kotfis K, Williams Roberson S, Wilson JE, Dabrowski W, Pun BT, Ely EW. COVID-19: ICU delirium management during SARS-CoV-2 pandemic. Crit Care. 2020; 24: 176.
• Referans16. Van Rompaey B, Elseviers MM, Schuurmans MJ, Shortridge-Baggett LM, Truijen S, Bossaert L. Risk factors for delirium in intensive care patients: a prospective cohort study. Crit Care. 2009; 13.
• Referans17. Ely EW, Margolin R, Francis J, May L, Truman B, Dittus R et al. Evaluation of delirium in critically ill patients: validation of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). Crit Care Med. 2001; 29: 1370–9.
• Referans18. Duggan MC, Vanc J, Ely EW. Delirium Assessment in Critically Ill Older Adults: Considerations During the COVID-19 Pandemic. Crit Care Clin. 2021; 37:175–90.
• Referans19. Han JH, Wilson A, Vasilevskis E, Shintani A, Schnelle JF, Dittus RS et all. Diagnosing Delirium in Older Emergency Department Patients: Validity and Reliability of the Delirium Triage Screen and the Brief Confusion Assessment Method. Ann Emerg Med. 2013; 62: 457-65.
• Referans20. Gusmao-Flores D, Salluh JI, Chalhub RÁ, Quarantini LC. The confusion assessment method for the intensive care unit (CAM-ICU) and intensive care delirium screening checklist (ICDSC) for the diagnosis of delirium: a systematic review and meta-analysis of clinical studies. Crit Care. 2012 3; 16: 115.
• Referans21. Carvalho JPLM, de Almeida ARP, Gusmao-Flores D. Delirium rating scales in critically ill patients: a systematic literature review Rev Bras Ter Intensiva. 2013; 25: 148-54.
• Referans22. Plaschke K, von Haken R, Scholz M, Engelhardt R, Brobeil A, Martin E et al. Comparison of the confusion assessment method for the intensive care unit (CAM-ICU) with the Intensive Care Delirium Screening Checklist (ICDSC) for delirium in critical care patients gives high agreement rate(s). Intensive Care Med. 2008; 34: 431–6.
• Referans23. Marra A, Kotfis K, Hosie A, MacLullich AMJ, Pandharipande PP, Ely EW et al. Delirium monitoring: yes or no? That is the question. Am J Crit Care. 2019; 28: 127–35.
• Referans24. Akıncı SB, Şahin A. Yoğun bakımda deliryum. Yoğun Bakım Dergisi. 2005; 5: 26-35.
• Referans25. Devlin JW, Skrobik Y, Gelinas C, Needham DM, Slooter AJC, Pandharipande PP et al. Clinical practice guidelines for the prevention and management of pain, agitation/sedation, delirium, immobility, and sleep disruption in adult patients in the ICU. Crit Care Med. 2018; 46: 825-73.
• Referans26. LaHue SC, James TC, Newman JC, Esmaili AM, Ormseth CH, Ely W. Collaborative delirium prevention in the age of Covid-19. Letters to the editor; J Am Geriatr Soc. 2020; 68: 947-49.
• Referans27. Pun BT, Balas MC, Barnes-Daly MA, Thompson JL, Aldrich JM, Barr J et al. Caring for critically ill patients with the ABCDEF bundle: results of the ICU liberation collaborative in over 15,000 adults. Crit Care Med. 2019; 47: 3–14.
• Referans28. Fischer T, Hosie A, Luckett T Agar M, Phillips J. Strategies for Pain Assessment in Adult Patients With Delirium: A Scoping Review. J of Pain and Symptom Manage. 58; 487-502.
• Referans29. Baller EB, Hogan CS, Fusunyan MA, Ivkovic A, Luccarelli JW, Madva E et al. Neurocovid: Pharmacological Recommendations for Delirium Associated With COVID-19. Psychosomatics 2020: 61: 585–96.
• Referans30. Shen Q-H, Li H-F, Zhou X-Y, Yuan X-Z: Dexmedetomidine in the prevention of postoperative delirium in elderly patients following non-cardiac surgery: a systematic review and metaanalysis. Clin Exp Pharmacol Physiol. 2020; 47: 1333–41.
• Referans31. Skrobik Y, Duprey MS, Hill NS, Devlin JW. Low-dose nocturnal dexmedetomidine prevents ICU delirium. A randomized, placebo-controlled trial. Am J Respir Crit Care Med 2018; 197: 1147–56.
• Referans32. Rubino AS, Onorati F, Caroleo S, Galato E, Nucera S, Amantea B, et al: Impact of clonidine administration on delirium and related respiratory weaning after surgical correction of acute type-A aortic dissection: results of a pilot study. Interact Cardiovasc Thorac Surg. 2010; 10: 58-62.
• Referans33. Gowing L, Farrell M, Ali R, White JM. Alpha₂-adrenergic agonists for the management of opioid withdrawal. Cochrane Database Syst Rev. 2016; 10: 58–62.
• Referans34. Hardeland R. Melatonin in aging and disease —multiple consequences of reduced secretion, options and limits of treatment. Aging Dis. 2012; 3: 194–225.
• Referans35. Simko F, Reiter R.J, Pechanova O, Paulis L. Experimental models of melatonin-deficient hypertension. Front. Biosci. (Landmark Ed). 2013; 18: 616–25.
• Referans36. Tutuncu NB, Batur M.K, Yildirir A. Melatonin levels decrease in type 2 diabetic patients with cardiac autonomic neuropathy. J Pineal Res. 2005; 39: 43–49.
• Referans37. Dominguez-Rodriguez A, Abreu-Gonzalez P, Arroyo-Ucar E, Reiter RJ. Decreased level of melatonin in serum predicts left ventricular remodelling after acute myocardial infarction. J Pineal Res. 2012; 53: 319–23.
• Referans38. Zambrelli E, Canevini M, Gambini O, D'Agostino A. Delirium and sleep disturbances in COVID-19: a possible role for melatonin in hospitalized patients? Sleep Med. 2020; 70: 111.
• Referans39. Bourne RS, Mills GH, Minelli C: Melatonin therapy to improve nocturnal sleep in critically ill patients: encouraging results from a small randomised controlled trial. Crit Care. 2008; 12: 52.
• Referans40. Zhang R, Wang X, Ni L, Di X, Ma B, Niu S et al. COVID-19: melatonin as a potential adjuvant treatment. Life Sci. 2020; 250: 117583.
• Referans41. Shneider A, Kudriavtsev A, Vakhrusheva A. Can melatonin reduce the severity of COVID-19 pandemic? Int Rev Immunol. 2020; 29: 1-10.
• Referans42. Prommer E. Aripiprazole: A New Option in Delirium. Am J Hosp Palliat Care. 2017; 34: 180–5.
• Referans43. Liverpool Drug Interaction Group 2020. https://www.covid19-druginteractions.org/checker
• Referans44. Martinotti G, Barlati S, Prestia D, Palumbo C, Giordani M, Cuomo A et al. Psychomotor agitation and hyperactive delirium in COVID-19 patients treated with aripiprazole 9.75 mg/1.3 ml immediate release. Psychopharmacology (Berl). 2020; 21: 1–5.
• Referans45. Shen Y, Peng K, Zhang J, Meng X, Ji F. Effects of haloperidol on delirium in adult patients: a systematic review and meta-analysis. Med Princ Pract. 2018; 27: 250–9.
• Referans46. Gordon DE, Jang GM, Bouhaddou M, Xu J, Obernier K, White KM et al. A SARS-CoV- 2 protein interaction map reveals targets for drug repurposing. Nature. 2020: 1–13.
• Referans47. Khorassani F, Saad M. Intravenous olanzapine for the management of agitation: review of the literature. Ann Pharmacother. 2019; 53: 853–9.
• Referans48. Beach S, Praschan N, Hogan C, Dotson S, Merideth F, Kontos N et al. Delirium in COVID-19: a case series and exploration of potential mechanisms for central nervous system involvement. Gen. Hosp. Psychiatr. 2020; 65: 47-53.
• Referans49. Haeusler IL, Chan XHS, Guérin PJ, White NJ. The arrhythmogenic cardiotoxicity of the quinoline and structurally related antimalarial drugs: a systematic review. BMC Med. 2018; 16: 200.
• Referans50. Ojeahere MI, de Filippis R, Ransing R, Karaliuniene R, Ullah I, Bytyçi DG et al. Management of psychiatric conditions and delirium during the COVID-19 pandemic across continents: lessons learned and recommendations. Brain Behav Immun Health. 2020; 9 : 100147.
• Referans51. Plasencia-García BO, Rodríguez-Menéndez G, Rico-Rangel MI, Rubio-García A, Torelló-Iserte J, Crespo-Facorro B. Psychopharmacology (Berl). 2021; 238: 329-40.
• Referans52. Gagnon DJ, Fontaine GV, Smith KE, Riker RR, Miller RR, Lerwick PA et al: Valproate for agitation in critically ill patients: a retrospective study. J Crit Care. 2017; 37:119–25.
• Referans53. Yang SY, Liao YT, Liu, HC, Chen WJ, Chen CC, Kuo CJ. Antipsychotic Drugs, Mood Stabilizers, and Risk of Pneumonia in Bipolar Disorder: A Nationwide Case-Control Study. J Clin Psychiatry. 2013; 74: 79-86.
• Referans54. Grieb P, Świątkiewicz M, Prus K, Rejdak K. Amantadine for COVID-19. J Clin Pharmacol. 2021; 61: 412-3.
• Referans55. Fryml LD, Williams KR, Pelic CG, Fox J, Sahlem G, Robert S et al. The role of amantadine withdrawal in 3 cases of treatment-refractory altered mental status. J Psychiatr Pract. 2017; 23: 191–9.
• Referans56. LaHue SC, James TC, Newman JC, Esmaili AM, Ormseth CH, Ely EW. Collaborative Delirium Prevention in the Age of COVID-19. J Am Geriatr Soc. 2020; 68: 947-9.
• Referans57. Khawam E, Khouli H, Pozuelo L. Treating acute anxiety in patients with COVID 19. Cleve Clin J Med. 2020; 14. https://doi.org/10.3949/ccjm.87a.ccc0
• Referans58. Naghibi T, Shafigh N, Mazloomzadeh S. Role of omega-3 fatty acids in the prevention of delirium in mechanically ventilated patients. J Res Med Sci. 2020; 25: 10.
• Referans59. Hawkins M, Sockalingam S, Bonato S, Rajaratnam T, Ravindran M, Gosse P et al. A rapid review of the pathoetiology, presentation, and management of delirium in adults with COVID-19. J Psychosom Res. 2021; 141:110350.
• Referans60. National Institute for Health and Care Excellence (NICE) in collaboration with NHS England and NHS Improvement Managing COVID-19 symptoms (including at the end of life) in the community: summary of NICE guidelines. BMJ. 2020; 369: 1461.
• Referans61. Sher Y, B. Rabkin B, Maldonado JR, Mohabir P. COVID-19–associated hyperactive intensive care unit delirium with proposed pathophysiology and treatment: a case report, Psychosomatics. 2020; 61: 544-50.