What Is Delirium?: Postoperative Delirium Recovery

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What Is Delirium?

Delirium is a condition of sudden severe confusion and rapid brain function changes that occur with a physical and mental disorder.

Delirium is an impairment of consciousness disorientation and disturbances in perception and restlessness”.

It is also known as acute brain syndrome or critical confusional state.

It is more of a state than the disease that occurs due to several etiological factors.

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Table of Contents

Categories of delirium

Delirium due to general medical:

Like infection, fluid and electrolyte disorder, head injury, etc.

Substance-induced delirium:

It may occur due to specific medication or addictive drugs

Substance withdrawal delirium

May occur due to reduction or termination of specific substances like alcohol, sedatives, drugs, etc.

I also covered Withdrawal Alcohol Abuse  in depth. You must read.

Causes and risk factors of delirium

  • It may be the result of physical or mental illness and are usually temporary and reversible.
  • Metabolic disease like metabolic acidosis
  • Endocrine disease like DKA
  • Intracranial disease like epilepsy, head injury, bleeding, stroke
  • Mood disorders, such as anxiety and depression
  • Other causes like post-operative state, sleep deprivation, addiction

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Signs and symptoms of delirium

  • Poor memory, particularly of recent events.
  • Disorientation: for example, not knowing where you are or who you are.
  • Difficulty speaking or recalling words.
  • Rambling or nonsense speech
  • Trouble understanding speech
  • Difficulty reading or writing
  • Seeing things that don’t exist (hallucinations)
  • Restlessness, agitation, or combative behavior
  • Being quiet and withdrawn —especially in older adults
  • Slowed movement or lethargy
  • Disturbed sleep habits
  • Anxiety, fear, or paranoia
  • Depression
  • Irritability or anger
  • Apathy
  • Rapid and unpredictable mood shifts
  • Personality changes

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Diagnosis

Confusion assessment method

Healthcare professionals use the Confusion Assessment Method to help them diagnose delirium. They will look for the indications of delirium during a CAM assessment:

  • Acute onset
  • Inattention
  • Disorganized thinking
  • Memory impairment
  • Psychomotor retardation

Some physical tests

The following test helps them check for imbalances in a person’s brain chemistry and electrolyte levels and verify the presence of any medical conditions:

  • Blood test
  • Urine test
  • ESR
  • CBC
  • X-ray skull
  • CT scan of the skul
  • MRI of the skull
  • Electroencephalography
  • Brain biopsy
  • Thyroid test

Management

  • Identification of cause and its immediate correction is the primary goal of treatment. Medications can be given according to the cause of the disease. With that, supportive care should be given, which includes the following.
  • Encouraging family members or familiar people for involvement.
  • Supportive care/nonpharmacological intervention:

Supportive care aims to prevent complications by:

  • Protecting the airway
  • Providing fluids and nutrition
  • Assisting with movement
  • Treating pain
  • Addressing incontinence

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Postoperative delirium recovery

Most cases of delirium last a week, with symptoms that slowly decline as the patient recovers from surgery. However, the condition can last for weeks and months in patients with underlying cognitive trials such as hearing impairment, dementia, vision, or a history of postoperative delirium.

Conclusion

Recovery from delirium is possible with excellent treatment. It can take few weeks for you to speak, think, and feel physically like your old self.

You have side effects from the medications used to treat this condition. Ask your doctor about any concerns you may have.

Start early diagnosis and treatment may decrease the risk of future complications.

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