Evaluation if Physostigmine Reduces Symptoms in Patients Who Has Developed a Delirium in Intensive Care After a Surgery

Inclusion Criteria: * Patients of both genders aged \> 18 years, \< 85 years of ICU C1 after elective or emergency heart surgery with or without extracorporeal circulation (heart-lung machine and/or extracorporeal membrane oxygenation), with suspected delirium. (May be suspected if a patient does not show adequate improvement of vigilance 24 h after adequate reduction or stop of sedative medicine) * Patients (\>18a, \<85a) with CAM-ICU diagnosed delirium * Patients of legal capacity and patients with appointed representative Exclusion Criteria: * Asthma * hypersensitivity against Physostigmine salicylate, Sodium metabisulfite, Nitrogen * gangrene mechanical obstipation * mechanical urinary retention * Dystrophia myotonica * Depolarization block after depolarising muscle relaxants * Intoxications with "irreversibly acting" cholinesterase inhibitors * closed head trauma * obstructions at gastro-intestinal tract and at urinary tract * neurological diseases * left ventricular ejection fraction \< 40% * Simultaneous Participation in other clinical trials or participation ind other clinical trials in the last 30 days * untreated coronary heart disease * wish to have children, pregnancy or nursing * patients with addictive disorder in medical history