Interventions for preventing delirium in adults in an intensive care unit
Citation: Herling SF, Greve IE, Vasilevskis EE, et al. Interventions for preventing intensive care unit delirium in adults. Cochrane Database of Systematic Reviews 2018; (11): CD009783
What is this? Some patients with COVID-19 will become critically ill and need treatment in an intensive care unit (ICU). One potential complication of this is the development of delirium, which has been associated with longer stays in ICU or hospital, greater risk of early death and long-term cognitive impairment. Various interventions have been tested to try to prevent delirium in patients in ICU.
In this Cochrane systematic review, the authors searched for randomized trials evaluating any intervention for preventing delirium in adult patients in ICU. They did not restrict by date or language of publication and did their searches in April 2018. They included 12 randomized trials (3885 participants). They also identified 5 studies that are awaiting classification and 15 ongoing studies.
What works: Nothing noted.
What doesn’t work: Haloperidol did not significantly lower the rate of ICU delirium.
What’s uncertain: Dexmedetomidine may reduce the risk of developing delirium and shorten ICU stay for patients receiving non-invasive mechanical ventilation.
The effects of many pharmacological and non-pharmacological interventions used to try to prevent delirium in adults patents in ICU are uncertain.
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