KALP CERRAHiSi HASTALARINDA DELiRYUM VE HEM§iREUK BAKIMI

Fatma Demir Korkmaz; Ayla Yavuz Karamanoglu; Fadime Gok

DELIRIUM IN CARDIAC SURGERY PATIENTS AND NURSING CARE

Yıl 2015, Cilt: 31 Sayı: 2, 113 - 129, 01.06.2015

Fatma Demir Korkmaz Ayla Yavuz Karamanoglu Fadime Gok

Öz

Although delirium is a common problem in patients after cardiothoracic surgery is often not realized or is misdiagnosed. Not diagnosing the patient with delirium may cause inability to treat delirium in a timely manner, worsening of patient's clinical condition and even death of the patient. However, diagnosing and raising awareness about delirium and different types of delirium greatly affects early detection rates and helps prevention. In this context, nurses are in an important position within the health system regarding increasing the rate of diagnosing, preventing, managing delirium and providing necessary care. This article discusses risk groups and reasons for delirium, signs and symptoms, treatment, interventions to prevent progression of delirium before, during and after surgical operations and nursing care

Anahtar Kelimeler

Cardiac surgery, delirium, nursing care

Kaynakça

Ameliyat sonrası deliryumu önlemede etkili girişimleri tanımlayan güçlü kanıtlara dayandırılmış çalışma bulunmamaktadır ve bu konuda randomize kontrollü çalışmalara gereksinim duyulmaktadır. Agar M, DraperB, Phillips PA & et al. Making Decisions about Delirium: A Qualitative Comparison of
Decision Making between Nurses Working in Palliative Care, Aged Care, Aged Care Psychiatry, and
Oncology. Palliative Medicine 2011; 26(7): 887- 96. Akarsu Ayazoğlu T, Tür H, Bolat C ve ark. Yaşlılarda Kardiyak Cerrahi Sonrası Yoğun Bakımda Deliryum
Prevalansı ve Risk Faktörleri. J. Exp. Clin. Med., 2012; 29:101-7. Akıncı SB, Şahin A. Yoğun Bakımda Deliryum. Yoğun Bakım Dergisi 2005; 5(1): 26-35. Astaneh AN, Khajehmougahi N, Pakseresht S & et aa. The Multi Component Intervention to Prevent
Postoperative Delirium after Open-Heart Surgery. Pak J Med Sci 2007; 23(2): 188-92. Balas MC, Rice M, Chaperon C & et al. Management of Delirium in Critically Ill Older Adults. Critical
Care Nurse 2012; 32(4):15-26. Burns KD, Jenkins W, Yeh D & et al. Delirium After Cardiac Surgery: A Retrospective Case-Control
Study of Incidence and Risk Factors in a Canadian Sample. BC Medical Journal 2009; 51(5): 206-10. Caplan G. Managing Delirium in Older Patients. Aust Prescr 2011; 34(1): 16-8. Carpenito-Moyet LJ. Hemşirelik Tanıları El Kitabı. Çeviren: Erdemir F. Nobel Tıp Kitabevleri; 2005. Cerejeira J, Mukaetova-Ladinska EB. A Clinical Update on Delirium: From Early Recognition to Effective
Management. Hindawi Publishing Corporation Nursing Research and Practice 2011; 2011:1-12. Chan MT, Cheng BC, Lee T M & et al. BIS-Guided Anesthesia Decreases Postoperative Delirium and
Cognitive Decline. Journal of Neurosurgical Anesthesiology 2013; 25 (1): 33-42. Christensen M. An Estudy of Staff Nurses’ Knowledge of Delirium in the Medical ICU: An Asian
Perspective, Intensive and Critical Care Nursing 2014; 30 (1): 54-60. Crimi C, Bigatello LM. The Clinical Signifıcance of Delirium in the Intensive Care Unit. Transl Med
UniSa 2012; 2(1): 1-9. Deren S, Ün C, Temur İ ve ark. Postoperatif Erken Dönemdeki Deliryuma Yaklaşım. Türk Anest Rean Der
Dergisi 2010; 38(5): 388-94. Donnel MS, Timmins F. Quantitative Exploration of the Subjective Burden Experienced by Nurses when
Caring for Patients with Delirium. Journal of Clinical Nursing 2012; 21(17-18): 2488-98. Ettema RGA, Hoogendoorn ME, Kalkman CJ & et aa. Development of a Nursing Intervention to Prepare
Frail Older Patients for Cardiac Surgery (the PREDOCS Programme), Following Phase one of the
Guidelines of the Medical Research Council. European Journal of Cardiovascular Nursing November
0(0) 1-20. Ettema RGA, Koeven HV, Peelen LM & et aa. Preadmission Interventions to Prevent Postoperative
Complications in Older Cardiac Surgery Patients: A Systematic Review. International Journal of Nursing Studies 2014; 51 (2): 251-60. Ettema RGA. Predicting and Preventing Postoperative Decline in Older Cardiac Surgery Patients. Institute
for Nursing Studies and Research Centre for Innovations in Health Care University of Appied
Sciences Utrecht. Amsterdam: BOXPress BV, ‘s Hertogenbosch. 2014. Ss:86. Fan Y, Guo Y, Li Q & et al. A Review: Nursing of Intensive Care Unit Delirium. Journal of Neuroscience
Nursing 2012; 44(6): 307-16. Fong TG , Tulebaev SR, Inouye SK. Delirium in Elderly Adults: Diagnosis, Prevention and Treatment. Nat
Rev Neurol 2009; 5(4): 210-20. Foreman M, Mion L, Tryostad L & et al. Standard of Practice Protocol: Acute Confusion/Delirium.
Geriatric Nursing 1999; 20(3): 147-52. Gamberini M, Bolliger D, Lurati Buse GA & et aa. Rivastigmine for the Prevention of Postoperative
Delirium in Elderly Patients Undergoing Elective Cardiac Surgery a Randomized Controlled Trial. Crit
Care Med 2009; 37(5):1762-68. Girard TD , Pandharipande PP, Ely EW. Delirium in the Intensive Care Unit. Critical Care 2008;12(Suppl 3):S3. Gunther ML, Morandi A, Ely EW. Pathophysiology of Delirium the Intensive Care Unit. Crit Care Clin
24(1): 45-65. Güner P, Geenen O. Atlanması Kolay Bir Bozukluk: Deliryum. C.Ü.Hemşirelik Yüksekokulu Dergisi 2007; 11 (1): 37-46. Hamdan-Mansour AM, Farhan NA, Othman EH & et al. Knowledge and Nursing Practice of Critical Care
Nurses Caring for Patients with Delirium in Intensive Care Units in Jordan. The Journal of Continuing
Education in Nursing 2010; 41(12): 571-76. Horacek R, Prasko J, Mainerova B & et al. Delirium in Surgery Intensive Care Unit. Activitas Nervosa
Superior Rediviva 2011; 53( 3):121-33. Hudek K. Emergence Delirium: A Nursing Perspective. AORN J 2009; 89(3): 509-16. Inouye SK, T. Bogardus ST, Charpentier PA & et al. A Multicomponent Intervention to Prevent Delirium
in Hospitalized Older Patients. The New England Journal of Medicine 1999; 340(9):669-76. Kalisvaart KJ, Vreeswijk R, Jonghe JFM & et aa. Risk Factors and Prediction of Postoperative Delirium in
Elderly Hip-Surgery Patients: Implementation and Validation of a Medical Risk Factor Model. Journal
of American Geriatrics Society 2006; 54(5): 817-22. Kırpınar İ. Deliryum; Tanı, Oluş Nedenleri, Bakım ve Tedavi Yaklaşımları. Türkiye Klinikleri J Psychiatry
Special Topics 2009; 2(3): 1-13. Kjorven M, Rush K, Hole R. A Discursive Exploration of the Practices that Shape and Discipline Nurses’
Responses to Postoperative Delirium. Nursing Inquiry 2011; 18 (4): 325-35. Klinik Epidemiyoloji ve Sağlık Hizmetleri Değerlendirme Birimi (Clinical Epidemiology and Health Service
Evaluation Unit). Clinical practice guidelines for the management of delirium in older people.
Melbourne: Victorian Government Department of Human Services; October 2006. December Retrieved 21, 2014, from http:// docs. health. vic.gov.au/ docs/ doc/
A9F4D074829CD75ACA25785200120044/ $FILE/ delirium- cpg. pdf Kostas TRM, Zimmerman KM, Rudolph JL. Improving Delirium Care: Prevention, Monitoring and
Assessment. The Neurohospitalist 2013; 3(4): 194-202. Koster S, Henses AG, Oosterveld FGJ & et al. The Delirium Observation Screening Scale Recognizes
Delirium Early After Cardiac Surgery. European Journal of Cardiovascular Nursing 2009; 8(4): 309-14. Koster S, Hensens AG, Schuurmans M J & et al. Risk Factors of Delirium after Cardiac Surgery a
Systematic Review. European Journal of Cardiovascular Nursing 2011; 10(4): 197-204. Koster S. Delirium in cardiac surgery. A study on risk-assessment and long-term consequences.Thesis
Department of Cardiothoracic Surgery, University of Twente. 2011.130-136.Retrieved December
2014. http://doc.utwente.n1/78245/1/thesis_S_Koster.pdf Kulaksızoğlu IB. Yoğun Bakım Şartlarında Deliryum ve Psikiyatrik Sorunlar. Yoğun Bakım Derneği Dergisi
4(1): 77-82. Küçük L, Kaya H. Koroner Yoğun Bakım Sürecinde Yaşanan Psikiyatrik Bir Durum: Deliryum Ne Kadar
Tanıyoruz?. Maltepe Üniversitesi Hemşirelik Bilim ve Sanatı Dergisi 2011; 4(1): 161-66. Lepouse' C, Lautner CA, Liu L & et al. Emergence Delirium in Adults in the Post-Anaesthesia Care Unit.
British Journal of Anaesthesia 2006; 96 (6): 747-53. Ling Chang BY, Fang Tsai Y, Jing Lin P & et aa. Prevalence and Risk Factors for Postoperative Delirium in
a Cardiovascular Intensive Care Unit. American Journal of Critical Care 2008;17 (6): 567-75. McPherson JA , Wagner CE, Boehm LM & et aa. Delirium in the Cardiovascular ICU: Exploring Modifiable
Risk Factors. Crit Care Med 2013; 41(2):405-13. Moyce Z, Rodseth N, Biccard BM. The Efficacy of Peri-operative Interventions to Decrease Postoperative
Delirium in Non-Cardiac Surgery: A Systematic Review and Meta-Analysis. Anaesthesia 2014;14(69): 259-69. Nelson JM. Recognizing, Preventing, and Managing Delirium in Hospital Patients. American Nurse Today
5(11): 43-5. Norkien I, Ringaitien D, Kuzminskait V & et aa. Incidence and Risk Factors of Early Delirium after Cardiac
Surgery. BioMed Research International 2013; 2013: 1-5. http://dx.doi.org/10.1155/2013/323491. Ommaty R. Vademecum Modern İlaç Rehberi. Medical Tribune Yayıncılık Ltd.Şti. Umut Matbacılık
İstanbul; 2010. Onur E, Cimilli C, Ulaş H. Psikiyatri Konsültasyonlarında Deliryum. Demans Dergisi 2003; 3(4):127-30. Onur E ve Cimilli C. Deliryum Tedavisinde Yeni Bir Yaklaşım: Atipik Antipsikotikler. Türk Psikiyatri
Dergisi 2005; 16(3): 216-24. Özdemir L. Yoğun Bakım Hastasında Deliryumun Yönetimi ve Hemşirenin Sorumlulukları. Hacettepe
Üniversitesi Hemşirelik Fakültesi Dergisi 2014; 90-98. Özkan M, Özkan S. Deliryumun Nedenleri ve Tedavisi. Klinik Gelişim 2009; 22(4):56-60. Rudolph JL, Jones RN, Levkoff SE & et al. Derivation and Validation of a Preoperative Prediction Rule for
Delirium after Cardiac Surgery. Circulation 2009;119 (2):229-36. Salman N, Durukan AB, Gürbüz H A ve ark. Koroner Arter Bypass Cerrahisinde Postoperatif
Serebrovasküler Olay ve Deliryum için Risk Faktörlerinin Belirlenmesi. Anestezi Dergisi 2013; 21 (4): 209-15. Sendelbach S, Guthrie PF. Evidence-Based Guideline Acute Confusion/Delirium Identification
Assessment, Treatment, and Prevention. Journal of Gerontological Nursing 2009; 35(11):11-8. Sezer O. Koroner bypass cerrahisi geçiren hastalarda deliryum risk faktörleri ve deliryum gelişiminin nitrik
oksit düzeyleriyle ilişkisi. Uzmanlık Tezi. Malatya: Malatya İnönü Üniversitesi Tıp Fakültesi: 2003. Sezer Ö, Karlıdağ R, Bay Karabulut A ve ark. Koroner Bypass Ameliyatı Geçiren Hastalarda Deliryum
Gelişiminin Nitrik Oksit Düzeyleriyle İlişkisi. Klinik Psikofarmakoloji Bülteni 2004; 14(4):185-90. Taipale PG. Nursing care and post-operative delirium in the cardiac surgery intensive care unit. A thesis submitted in partial fulfillment of the requirements for the degree of master of science in nursing in the faculty of graduate studies. Vancouver: The University of British Columbia: 2010. 1-128. Topuz Ş, Doğan N. Bir Üniversite Hastanesinin Yoğun Bakım Ünitelerinde Çalışan Hemşirelerin Deliryum
Konusuna İlişkin Bilgi Düzeyleri. KTU Tıp Fak Derg 2012; 14(3): 21-6. Tullmann DF, Mion LC, Fletcher K & et al. Delirium. In: Boltz M, Capezuti E, Fulmer T, Zwicker D
Editor(s). Evidence-based geriatric nursing protocols for best practice. 4th ed. New York: Springer Publishing Company; 2012. 186-99. Retrieved December 18, 2014» from
guideline.gov/content.aspx?id=43920 http://www. Türkcan A. Deliryum. Psikiyatri Dünyası 2001; 5(1):15-23. Ulusal Sağlık ve Bakım Mükemmellik Enstitüsü (National Institute for Health and Care Excellence-NICE)
Rehberi. Delirium: Evidence Update April 2012. A summary of selected new evidence relevant to NICE clinical guideline. Delirium: diagnosis, prevention and management’(2010). Retrieved August
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Rehberi. Delirium diagnosis, prevention and management. Issued: July 2010 Retrieved August 18
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http://www.akademikgeriatri.org/geriatri_konusmaci_metinleri/24.pdf. Yılmaz E, Aksun M, Girgin S ve ark. Elektif Koroner Arter Baypas Greft Ameliyatlarında Off-Pump ve On
Pump Kardiyopulmoner Baypas Tekniklerinin Postoperatif Deliryum Gelişimi Üzerine Etkilerinin Karşılaştırılması. GKDA Derg 2013; 19(2): 67-75. Zhang H, Lu Y, Liu M & et al. Strategies for Prevention of Postoperative Delirium: A Systematic Review
and Meta-Analysis of Randomized Trials. Critical Care 2013; 17(2):3-21.

KALP CERRAHiSi HASTALARINDA DELiRYUM VE HEM§iREUK BAKIMI

Yıl 2015, Cilt: 31 Sayı: 2, 113 - 129, 01.06.2015

Fatma Demir Korkmaz Ayla Yavuz Karamanoglu Fadime Gok

Öz

ragmen, gogu zaman taninmamakta veya yanli§ te§his edilmektedir. Hastanm deliryumda oldugunun fark edilmemesi deliryum tedavisinin zamaninda yapilamamasina, hastanm klinik durumunun daha kotiiye gitmesine hatta bazen hastanm olumune neden olabilir. Halbuki deliryumun tammlanmasi ve tipleri ile ilgili farkindaligin arttirilmasi, erken te§his edilme oranlarim etkileyebilmekte ve deliryum biiyuk olgiide onlenebilmektedir. Hem§ireler deliryumu tanilama oranini arttirmada, deliryumu onleme, yonetme ve hastalara gerekli bakimin verilmesinde saglik sistemi i^erisinde onemli bir pozisyondadirlar. Bu makalede deliryumun risk gruplari ve nedenleri, belirti ve bulgulari, tarn yontemleri, tedavisi, deliryum geli§imini onlemeye yonelik ameliyat oncesi, sirasi ve sonrasi giri§imler ve deliryumda hem$irelik bakimi ele alinmijtir

Anahtar Kelimeler

Kalp cerrahisi, deliryum, hem§irelik bakimi

Kaynakça

Ameliyat sonrası deliryumu önlemede etkili girişimleri tanımlayan güçlü kanıtlara dayandırılmış çalışma bulunmamaktadır ve bu konuda randomize kontrollü çalışmalara gereksinim duyulmaktadır. Agar M, DraperB, Phillips PA & et al. Making Decisions about Delirium: A Qualitative Comparison of
Decision Making between Nurses Working in Palliative Care, Aged Care, Aged Care Psychiatry, and
Oncology. Palliative Medicine 2011; 26(7): 887- 96. Akarsu Ayazoğlu T, Tür H, Bolat C ve ark. Yaşlılarda Kardiyak Cerrahi Sonrası Yoğun Bakımda Deliryum
Prevalansı ve Risk Faktörleri. J. Exp. Clin. Med., 2012; 29:101-7. Akıncı SB, Şahin A. Yoğun Bakımda Deliryum. Yoğun Bakım Dergisi 2005; 5(1): 26-35. Astaneh AN, Khajehmougahi N, Pakseresht S & et aa. The Multi Component Intervention to Prevent
Postoperative Delirium after Open-Heart Surgery. Pak J Med Sci 2007; 23(2): 188-92. Balas MC, Rice M, Chaperon C & et al. Management of Delirium in Critically Ill Older Adults. Critical
Care Nurse 2012; 32(4):15-26. Burns KD, Jenkins W, Yeh D & et al. Delirium After Cardiac Surgery: A Retrospective Case-Control
Study of Incidence and Risk Factors in a Canadian Sample. BC Medical Journal 2009; 51(5): 206-10. Caplan G. Managing Delirium in Older Patients. Aust Prescr 2011; 34(1): 16-8. Carpenito-Moyet LJ. Hemşirelik Tanıları El Kitabı. Çeviren: Erdemir F. Nobel Tıp Kitabevleri; 2005. Cerejeira J, Mukaetova-Ladinska EB. A Clinical Update on Delirium: From Early Recognition to Effective
Management. Hindawi Publishing Corporation Nursing Research and Practice 2011; 2011:1-12. Chan MT, Cheng BC, Lee T M & et al. BIS-Guided Anesthesia Decreases Postoperative Delirium and
Cognitive Decline. Journal of Neurosurgical Anesthesiology 2013; 25 (1): 33-42. Christensen M. An Estudy of Staff Nurses’ Knowledge of Delirium in the Medical ICU: An Asian
Perspective, Intensive and Critical Care Nursing 2014; 30 (1): 54-60. Crimi C, Bigatello LM. The Clinical Signifıcance of Delirium in the Intensive Care Unit. Transl Med
UniSa 2012; 2(1): 1-9. Deren S, Ün C, Temur İ ve ark. Postoperatif Erken Dönemdeki Deliryuma Yaklaşım. Türk Anest Rean Der
Dergisi 2010; 38(5): 388-94. Donnel MS, Timmins F. Quantitative Exploration of the Subjective Burden Experienced by Nurses when
Caring for Patients with Delirium. Journal of Clinical Nursing 2012; 21(17-18): 2488-98. Ettema RGA, Hoogendoorn ME, Kalkman CJ & et aa. Development of a Nursing Intervention to Prepare
Frail Older Patients for Cardiac Surgery (the PREDOCS Programme), Following Phase one of the
Guidelines of the Medical Research Council. European Journal of Cardiovascular Nursing November
0(0) 1-20. Ettema RGA, Koeven HV, Peelen LM & et aa. Preadmission Interventions to Prevent Postoperative
Complications in Older Cardiac Surgery Patients: A Systematic Review. International Journal of Nursing Studies 2014; 51 (2): 251-60. Ettema RGA. Predicting and Preventing Postoperative Decline in Older Cardiac Surgery Patients. Institute
for Nursing Studies and Research Centre for Innovations in Health Care University of Appied
Sciences Utrecht. Amsterdam: BOXPress BV, ‘s Hertogenbosch. 2014. Ss:86. Fan Y, Guo Y, Li Q & et al. A Review: Nursing of Intensive Care Unit Delirium. Journal of Neuroscience
Nursing 2012; 44(6): 307-16. Fong TG , Tulebaev SR, Inouye SK. Delirium in Elderly Adults: Diagnosis, Prevention and Treatment. Nat
Rev Neurol 2009; 5(4): 210-20. Foreman M, Mion L, Tryostad L & et al. Standard of Practice Protocol: Acute Confusion/Delirium.
Geriatric Nursing 1999; 20(3): 147-52. Gamberini M, Bolliger D, Lurati Buse GA & et aa. Rivastigmine for the Prevention of Postoperative
Delirium in Elderly Patients Undergoing Elective Cardiac Surgery a Randomized Controlled Trial. Crit
Care Med 2009; 37(5):1762-68. Girard TD , Pandharipande PP, Ely EW. Delirium in the Intensive Care Unit. Critical Care 2008;12(Suppl 3):S3. Gunther ML, Morandi A, Ely EW. Pathophysiology of Delirium the Intensive Care Unit. Crit Care Clin
24(1): 45-65. Güner P, Geenen O. Atlanması Kolay Bir Bozukluk: Deliryum. C.Ü.Hemşirelik Yüksekokulu Dergisi 2007; 11 (1): 37-46. Hamdan-Mansour AM, Farhan NA, Othman EH & et al. Knowledge and Nursing Practice of Critical Care
Nurses Caring for Patients with Delirium in Intensive Care Units in Jordan. The Journal of Continuing
Education in Nursing 2010; 41(12): 571-76. Horacek R, Prasko J, Mainerova B & et al. Delirium in Surgery Intensive Care Unit. Activitas Nervosa
Superior Rediviva 2011; 53( 3):121-33. Hudek K. Emergence Delirium: A Nursing Perspective. AORN J 2009; 89(3): 509-16. Inouye SK, T. Bogardus ST, Charpentier PA & et al. A Multicomponent Intervention to Prevent Delirium
in Hospitalized Older Patients. The New England Journal of Medicine 1999; 340(9):669-76. Kalisvaart KJ, Vreeswijk R, Jonghe JFM & et aa. Risk Factors and Prediction of Postoperative Delirium in
Elderly Hip-Surgery Patients: Implementation and Validation of a Medical Risk Factor Model. Journal
of American Geriatrics Society 2006; 54(5): 817-22. Kırpınar İ. Deliryum; Tanı, Oluş Nedenleri, Bakım ve Tedavi Yaklaşımları. Türkiye Klinikleri J Psychiatry
Special Topics 2009; 2(3): 1-13. Kjorven M, Rush K, Hole R. A Discursive Exploration of the Practices that Shape and Discipline Nurses’
Responses to Postoperative Delirium. Nursing Inquiry 2011; 18 (4): 325-35. Klinik Epidemiyoloji ve Sağlık Hizmetleri Değerlendirme Birimi (Clinical Epidemiology and Health Service
Evaluation Unit). Clinical practice guidelines for the management of delirium in older people.
Melbourne: Victorian Government Department of Human Services; October 2006. December Retrieved 21, 2014, from http:// docs. health. vic.gov.au/ docs/ doc/
A9F4D074829CD75ACA25785200120044/ $FILE/ delirium- cpg. pdf Kostas TRM, Zimmerman KM, Rudolph JL. Improving Delirium Care: Prevention, Monitoring and
Assessment. The Neurohospitalist 2013; 3(4): 194-202. Koster S, Henses AG, Oosterveld FGJ & et al. The Delirium Observation Screening Scale Recognizes
Delirium Early After Cardiac Surgery. European Journal of Cardiovascular Nursing 2009; 8(4): 309-14. Koster S, Hensens AG, Schuurmans M J & et al. Risk Factors of Delirium after Cardiac Surgery a
Systematic Review. European Journal of Cardiovascular Nursing 2011; 10(4): 197-204. Koster S. Delirium in cardiac surgery. A study on risk-assessment and long-term consequences.Thesis
Department of Cardiothoracic Surgery, University of Twente. 2011.130-136.Retrieved December
2014. http://doc.utwente.n1/78245/1/thesis_S_Koster.pdf Kulaksızoğlu IB. Yoğun Bakım Şartlarında Deliryum ve Psikiyatrik Sorunlar. Yoğun Bakım Derneği Dergisi
4(1): 77-82. Küçük L, Kaya H. Koroner Yoğun Bakım Sürecinde Yaşanan Psikiyatrik Bir Durum: Deliryum Ne Kadar
Tanıyoruz?. Maltepe Üniversitesi Hemşirelik Bilim ve Sanatı Dergisi 2011; 4(1): 161-66. Lepouse' C, Lautner CA, Liu L & et al. Emergence Delirium in Adults in the Post-Anaesthesia Care Unit.
British Journal of Anaesthesia 2006; 96 (6): 747-53. Ling Chang BY, Fang Tsai Y, Jing Lin P & et aa. Prevalence and Risk Factors for Postoperative Delirium in
a Cardiovascular Intensive Care Unit. American Journal of Critical Care 2008;17 (6): 567-75. McPherson JA , Wagner CE, Boehm LM & et aa. Delirium in the Cardiovascular ICU: Exploring Modifiable
Risk Factors. Crit Care Med 2013; 41(2):405-13. Moyce Z, Rodseth N, Biccard BM. The Efficacy of Peri-operative Interventions to Decrease Postoperative
Delirium in Non-Cardiac Surgery: A Systematic Review and Meta-Analysis. Anaesthesia 2014;14(69): 259-69. Nelson JM. Recognizing, Preventing, and Managing Delirium in Hospital Patients. American Nurse Today
5(11): 43-5. Norkien I, Ringaitien D, Kuzminskait V & et aa. Incidence and Risk Factors of Early Delirium after Cardiac
Surgery. BioMed Research International 2013; 2013: 1-5. http://dx.doi.org/10.1155/2013/323491. Ommaty R. Vademecum Modern İlaç Rehberi. Medical Tribune Yayıncılık Ltd.Şti. Umut Matbacılık
İstanbul; 2010. Onur E, Cimilli C, Ulaş H. Psikiyatri Konsültasyonlarında Deliryum. Demans Dergisi 2003; 3(4):127-30. Onur E ve Cimilli C. Deliryum Tedavisinde Yeni Bir Yaklaşım: Atipik Antipsikotikler. Türk Psikiyatri
Dergisi 2005; 16(3): 216-24. Özdemir L. Yoğun Bakım Hastasında Deliryumun Yönetimi ve Hemşirenin Sorumlulukları. Hacettepe
Üniversitesi Hemşirelik Fakültesi Dergisi 2014; 90-98. Özkan M, Özkan S. Deliryumun Nedenleri ve Tedavisi. Klinik Gelişim 2009; 22(4):56-60. Rudolph JL, Jones RN, Levkoff SE & et al. Derivation and Validation of a Preoperative Prediction Rule for
Delirium after Cardiac Surgery. Circulation 2009;119 (2):229-36. Salman N, Durukan AB, Gürbüz H A ve ark. Koroner Arter Bypass Cerrahisinde Postoperatif
Serebrovasküler Olay ve Deliryum için Risk Faktörlerinin Belirlenmesi. Anestezi Dergisi 2013; 21 (4): 209-15. Sendelbach S, Guthrie PF. Evidence-Based Guideline Acute Confusion/Delirium Identification
Assessment, Treatment, and Prevention. Journal of Gerontological Nursing 2009; 35(11):11-8. Sezer O. Koroner bypass cerrahisi geçiren hastalarda deliryum risk faktörleri ve deliryum gelişiminin nitrik
oksit düzeyleriyle ilişkisi. Uzmanlık Tezi. Malatya: Malatya İnönü Üniversitesi Tıp Fakültesi: 2003. Sezer Ö, Karlıdağ R, Bay Karabulut A ve ark. Koroner Bypass Ameliyatı Geçiren Hastalarda Deliryum
Gelişiminin Nitrik Oksit Düzeyleriyle İlişkisi. Klinik Psikofarmakoloji Bülteni 2004; 14(4):185-90. Taipale PG. Nursing care and post-operative delirium in the cardiac surgery intensive care unit. A thesis submitted in partial fulfillment of the requirements for the degree of master of science in nursing in the faculty of graduate studies. Vancouver: The University of British Columbia: 2010. 1-128. Topuz Ş, Doğan N. Bir Üniversite Hastanesinin Yoğun Bakım Ünitelerinde Çalışan Hemşirelerin Deliryum
Konusuna İlişkin Bilgi Düzeyleri. KTU Tıp Fak Derg 2012; 14(3): 21-6. Tullmann DF, Mion LC, Fletcher K & et al. Delirium. In: Boltz M, Capezuti E, Fulmer T, Zwicker D
Editor(s). Evidence-based geriatric nursing protocols for best practice. 4th ed. New York: Springer Publishing Company; 2012. 186-99. Retrieved December 18, 2014» from
guideline.gov/content.aspx?id=43920 http://www. Türkcan A. Deliryum. Psikiyatri Dünyası 2001; 5(1):15-23. Ulusal Sağlık ve Bakım Mükemmellik Enstitüsü (National Institute for Health and Care Excellence-NICE)
Rehberi. Delirium: Evidence Update April 2012. A summary of selected new evidence relevant to NICE clinical guideline. Delirium: diagnosis, prevention and management’(2010). Retrieved August
2014» from https://www.evidence.nhs.uk/search?q=Delirium+evidence+update. Ulusal Sağlık ve Bakım Mükemmellik Enstitüsü (National Institute for Health and Care Excellence-NICE)
Rehberi. Delirium diagnosis, prevention and management. Issued: July 2010 Retrieved August 18
from http://www.nice.org.uk/guidance/cg103/resources/guidance-delirium-pdf. Üstek S, Boran M. Multipl Travmalı Hastada Postoperatif Gelişen Deliryum. Ege Tıp Dergisi/ Ege Journal
of Medicine 2010; 49 (1) :67-70. Yaşayacak A, Eker F. Kalp Damar Cerrahisi Yoğun Bakım Ünitesinde Yatan Hastalarda Deliryum ve Risk
Faktörlerinin Belirlenmesi. Türk Göğüs Kalp Damar Cerrahisi Dergisi 2012; 20(2): 265-74. Yavuz BB. Deliryum geriatri uzmanı gözüyle. Akademik Geriatri 2010; 178-80. Erişim: Ağustos 16, 2014»
http://www.akademikgeriatri.org/geriatri_konusmaci_metinleri/24.pdf. Yılmaz E, Aksun M, Girgin S ve ark. Elektif Koroner Arter Baypas Greft Ameliyatlarında Off-Pump ve On
Pump Kardiyopulmoner Baypas Tekniklerinin Postoperatif Deliryum Gelişimi Üzerine Etkilerinin Karşılaştırılması. GKDA Derg 2013; 19(2): 67-75. Zhang H, Lu Y, Liu M & et al. Strategies for Prevention of Postoperative Delirium: A Systematic Review
and Meta-Analysis of Randomized Trials. Critical Care 2013; 17(2):3-21.

Toplam 69 adet kaynakça vardır.

Ayrıntılar

Birincil Dil	Türkçe
Bölüm	Özgün Araştırma
Yazarlar	Fatma Demir Korkmaz Bu kişi benim Ayla Yavuz Karamanoglu Bu kişi benim Fadime Gok Bu kişi benim
Yayımlanma Tarihi	1 Haziran 2015
Yayımlandığı Sayı	Yıl 2015 Cilt: 31 Sayı: 2

Kaynak Göster

APA	Korkmaz, F. D., Karamanoglu, A. Y., & Gok, F. (2015). KALP CERRAHiSi HASTALARINDA DELiRYUM VE HEM§iREUK BAKIMI. Ege Üniversitesi Hemşirelik Fakültesi Dergisi, 31(2), 113-129.

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