Modern view on the problem of acute postoperative delirium in trauma and orthopedic patients in the intensive care unit

The purpose of the present literature review is a systematization of known evidence on the problem of postoperative delirium as a frequent complication in elderly and senile patients during extensive reconstructive surgery on the spine and large joints. The review, which is based on publications of foreign and native authors, provides insights into current understanding of the pathogenesis, risk factors, diagnosis, methods of treatment, and prevention of these complications. The number of operations in traumatology and orthopedy is increasing. Accordingly with this fact, we are seeing an increase the number of cases of postoperative delirium. We know that the risk of delirium is linked with patient age. The interest to this problem is growing and has clinical and economical background. The etiology of delirium is considered to be multivariate. The development of diagnostic tools is playing a very important role and provides control of delirium in intensive care unit. Common understanding of this state’s pathophysiology and the opportunity to participate another physician leads to correct organization of treatment process. The knowledge of acute postoperative delirium in intensive care unit is being formed. The basic concept of postoperative delirium varies from its definition psychiatry and narcology due to differences in how different specialties treat the disorder. The risk factors of treatment are estimated. The controlled sedation is a clear trend. The experience of practical application dexmedetomidin for prevention and treatment of postoperative delirium is accumulated. Although the value of drug- therapy is difficult to overestimate the great influence on the result have non- pharmalogical methods.