Pharmacological interventions for the treatment of delirium in critically ill adults
Citation: Burry L, Hutton B, Williamson DR, et al. Pharmacological interventions for the treatment of delirium in critically ill adults. Cochrane Database of Systematic Reviews 2019; (9): CD011749
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. A variety of drugs have been tested as treatments for delirium in ICU patients.
In this Cochrane systematic review and network meta-analysis, the authors searched for randomized and quasi-randomized trials of pharmacological interventions for treating delirium in critically ill adults. They did not restrict their search by type or language of publication and did the search in March 2019. They included 14 studies (1844 participants). They also identified 10 ongoing trials and 6 studies awaiting classification.
What works: Dexmedetomidine may shorten the duration of delirium in critically ill adults.
What doesn’t work: Rivastigmine was associated with harm (longer ICU stay).
What’s uncertain: There were no obvious effects on the duration of delirium or other outcomes for the other drugs in the studies included in the review: antipsychotics, statins, morphine and ondansetron. This may change depending on the results of the ongoing trials and studies awaiting classification.
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