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Yıl:2016; Cilt: 9; Sayı: 2>> Özet
Türkiye Klinikleri Psikiyatri Özel Dergisi; 2016;9(2):46-55
Deliryum ve Klinik Biyokimya
Ç Hocaoğlu, HM Aytaç
Recep Tayyip Erdoğan Üniversitesi, Rize
Deliryum, yoğun bilişsel bozukluk, uyku-uyanıklık siklusundaki değişiklikler, algısal yanılsamalar, içeren nöropsikiyatrik bir sendromdur. Tipik deliryum belirtileri ani başlangıçlıdır ve gün içinde dalgalanmalar gösterir. Deliryumun çoğunlukla dahili ve cerrahi dallarda tedavi gören hastalar ve özellikle merkez sinir sistemi yetersizliği olan yaşlılarda daha fazla risk taşıdığı klinik uygulamalarda gösterilmiştir. Artmış mortalite, morbidite ve uzamış hastane yatışları ile deliryum önemli sağlık harcamalarına de neden olmaktadır. Çok farklı tıbbi durumların seyri sırasında ortaya çıkan deliryumun patofizyolojisi tam olarak bilinmemektedir. Günümüzde deliryum tanı araçları kısıtlıdır. Farklı fizyolojik etkilere sahip geniş bir etiyolojik yelpazenin varlığı deliryum için güvenilir tanı araçlarının geliştirilmesini engellemektedir. Bu nedenle deliryum tanısını kolaylaştıracak biyokimyasal belirteçlerin olması hem deliryumun tanı özgüllüğünü arttıracak, hem de erken tanı olanağı ve deliryumu önleyici stratejilerin geliştirilmesine katkı sağlayacaktır. Böylece deliryuma ait mortalite, morbidite ve maliyetlerde de düşüş yaşanacaktır. Bu çalışmada deliryumun tanımı, etiyolojisi, patofizyolojisi ile deliryum tanısında kullanılabilecek biyolojik belirteçlerle ilgili son literatür bilgileri gözden geçirilmiştir.
Delirium and Clinical Biochemistry
Delirium is a neuropsychiatric syndrome that involves a number of symptoms, including diffuse cognitive impairment, sleep-wake cycle disturbance, perceptual disturbances. Symptoms of delirium typically have an acute onset and tend to fluctuate in intensity throughout a 24-hour period. Delirium is frequently observed in clinical practice, particularly in medical and surgical wards and more so among patients at risk, especially elderly with preexisting central nervous system impairments. Delirium also causes exaggerated health care payment with increasing mortality, morbidity and spending time in hospital. Although a lot of different disease can cause a delirium, pathophysiology of delirium is unknown. Diagnostic tools of delirium are limited at the present time. Existence of wide range etiologic parameters that have different physiologic effect, prevents to improve reliable diagnostic tools for delirium. For this reason; with biochemical markers which facilitate to make diagnosis of delirium; can be developed specific, predictive diagnostic tools and preventive strategies. Therefore decrease of mortality, morbidity and health care payment will be seen in paralel with these improvements. Aim is that to review the literature on delirium and to identify description, etiology, pathophysiology and biological markers of delirium based on recent literature.

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