文章：

临终谵妄的药理学管理：从证据到实践的转化

Pharmacologic Management of End-of-Life Delirium: Translating Evidence into Practice

原文发布日期：28 May 2024

DOI: 10.3390/cancers16112045

类型: Article

开放获取: 是

英文摘要：

End-of-life delirium affects a vast majority of patients before death. It is highly distressing and often associated with restlessness or agitation. Unlike delirium in other settings, it is considered irreversible, and non-pharmacologic measures may be less feasible. The objective of this review is to provide an in-depth discussion of the clinical trials on delirium in the palliative care setting, with a particular focus on studies investigating pharmacologic interventions for end-of-life delirium. To date, only six randomized trials have examined pharmacologic options in palliative care populations, and only two have focused on end-of-life delirium. These studies suggest that neuroleptics and benzodiazepines may be beneficial for the control of the terminal restlessness or agitation associated with end-of-life delirium. However, existing studies have significant methodologic limitations. Further studies are needed to confirm these findings and examine novel therapeutic options to manage this distressing syndrome.

摘要翻译： 

临终谵妄在患者死亡前影响绝大多数患者。该症状具有高度痛苦性，常伴随躁动或激越表现。与其他场景下的谵妄不同，临终谵妄通常被认为是不可逆转的，非药物干预措施的可行性也相对有限。本综述旨在深入探讨姑息治疗领域中关于谵妄的临床试验，特别聚焦于临终谵妄药物干预的研究。迄今为止，仅有六项随机试验在姑息治疗人群中检验了药物干预方案，其中仅有两项专门针对临终谵妄。这些研究表明，抗精神病药物和苯二氮䓬类药物可能有助于控制与临终谵妄相关的终末期躁动或激越症状。然而现有研究存在显著的方法学局限性，需要进一步研究来验证这些发现，并探索治疗这一痛苦综合征的新型治疗方案。

原文链接：

Pharmacologic Management of End-of-Life Delirium: Translating Evidence into Practice