Best evidence summary for the prevention and management of postoperative delirium in patients with Stanford type A aortic dissection
Journal Title: Chinese Journal of Clinical Research - Year 2024, Vol 37, Issue 9
Abstract
Objective To retrieve, evaluate, and integrate the best evidence related to the prevention and management of postoperative delirium in patients with Stanford type A aortic dissection at home and abroad. Methods Referring to the “6S” evidence level pyramid, a thorough search of the literature was conducted to find evidence on the prevention and treatment of postoperative delirium in Stanford type A aortic dissection patients. The database mainly included UpToDate, BMJ Best Practice, Registered Nurses' Association of Ontario, Guidelines International Network, National Institute for Health and Care Excellence of U.K., National Guideline Clearinghouse of U.S., Scottish Intercollegiate Guidelines Network, WHO, Medlive, JBI EBP, ACP Journal Club, Cochrane, PubMed, Web of Science, Embase, SinoMed, Wanfang, CNKI, VIP, etc. Literature types included clinical decision-making, clinical practice guidelines, systematic reviews, Meta-analysis and expert consensus. The search period was from the establishment of various databases until April 2023. The members of the research group conducted literature screening, quality evaluation, evidence extraction, and integration, and finally evaluated the level of evidence. Results One clinical decision, seven clinical practice guidelines, two Meta-analyses, and four expert consensuses were included. Through the synthesis of evidence, the best evidence summary for the prevention and management of postoperative delirium in Stanford type A aortic dissection patients was formed, mainly including the management principles of delirium, preoperative neurological examination, intraoperative brain protection, evaluation and monitoring of postoperative delirium, identification of delirium risk factors, prevention of delirium risk factors, non-pharmacological treatment of delirium, pharmacological treatment of delirium, and health follow-up after discharge. A total of 29 recommendations were formed. Conclusion This study summarizes the best evidence for the prevention and management of postoperative delirium in patients with Stanford type A aortic dissection, including the management principles of delirium, preoperative neurological examination, intraoperative brain protection, evaluation and monitoring of postoperative delirium, identification of delirium risk factors, prevention of delirium risk factors, non-pharmacological treatment of delirium, pharmacological treatment of delirium, and health follow-up after discharge. Medical institutions should carefully apply the evidence to clinical settings and patient preferences, in order to ensure the perioperative safety of Stanford type A aortic dissection patients and promote rehabilitation.
Authors and Affiliations
LU Shan , WANG Zheyi, ZHOU Xin, LIU Xiaoqing, YANG Tingting, XU Huanhuan, XIE Xiaoli, SU Yunyan, XUE Yunxing
Keywords
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- EP ID EP745462
- DOI 10.13429/j.cnki.cjcr.2024.09.015
- Views 22
- Downloads 0
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