Tratamento do Delirium em Doentes Hospitalizados com Necessidades Paliativas: Revisão Sistemática da Literatura
DOI:
https://doi.org/10.24950/rspmi.826Palavras-chave:
Cuidados Paliativos, Delírio/psicologia, Delírio/ tratamentoResumo
O delirium é uma alteração aguda e flutuante do estado cognitivo
e da atenção com uma causa subjacente. Nos doentes
hospitalizados com necessidades paliativas é um problema
frequente e com impacto importante. O objetivo desta revisão
sistemática foi analisar a evidência na literatura publicada
entre Abril de 2011 e Agosto de 2015, acerca do tratamento
do delirium nesta população. Foram encontradas 2539 referências,
das quais 9 cumpriram os critérios de inclusão. Dois
estudos avaliaram medidas não farmacológicas em idosos
vulneráveis. Encontrou-se apenas um estudo comparativo,
que não mostrou diferenças entre o haloperidol e o aripiprazole,
mas registou mais efeitos adversos com o primeiro. O
aripiprazole parece ser menos eficaz no delirium hiperativo.
Estão em estudo novos fármacos, como os análogos da melatonina.
As orientações publicadas derivam essencialmente
da opinião de peritos ou da extrapolação de dados de outros
contextos. São necessários estudos prospetivos comparativos
com grupo placebo, duplamente cegos e randomizados
e com tempo de seguimento mais prolongado. Nos doentes
com necessidades paliativas que desenvolvem delirium é
premente avaliar o potencial de reversibilidade do episódio,
garantir o suporte aos cuidadores e adoptar medidas farmacológicas
ou não farmacológicas que privilegiem a qualidade
de vida e os objetivos do doente e da família.
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Direitos de Autor (c) 2016 Medicina Interna
Este trabalho encontra-se publicado com a Licença Internacional Creative Commons Atribuição 4.0.
Direitos de Autor (c) 2023 Medicina Interna
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