Pharmacologic prevention and treatment of delirium in intensive care patients: A systematic review
Pharmacologic prevention and treatment of delirium in intensive care patients: A systematic review
dc.contributor.author | Serafim, Rodrigo B. | |
dc.contributor.author | Bozza, Fernando A. | |
dc.contributor.author | Soares, Marcio | |
dc.contributor.author | Brasil, Pedro Emanuel A.A. do | |
dc.contributor.author | Tura, Bernardo Rangel | |
dc.contributor.author | Ely, E. Wesley | |
dc.contributor.author | Salluh, Jorge I.F. | |
dc.date.accessioned | 2023-12-06T16:46:50Z | |
dc.date.available | 2023-12-06T16:46:50Z | |
dc.date.issued | 2015 | |
dc.description.abstract | Purpose: The purpose of the study is to determine if pharmacologic approaches are effective in prevention and treatment of delirium in critically ill patients. Materials and methods: We performed a systematic search to identify publications (from January 1980 to September 2014) that evaluated the pharmacologic interventions to treat or prevent delirium in intensive care unit (ICU) patients. Results: From 2646 citations, 15 studies on prevention (6729 patients) and 7 studies on treatment (1784 patients) were selected and analyzed. Among studies that evaluated surgical patients, the pharmacologic interventions were associated with a reduction in delirium prevalence, ICU length of stay, and duration of mechanical ventilation, but with high heterogeneity (respectively, I(2) = 81%, P = .0013; I(2) = 97%, P < .001; and I(2) = 97%). Considering treatment studies, only 1 demonstrated a significant decrease in ICU length of stay using dexmedetomidine compared to haloperidol (Relative Risk, 0.62 [1.29-0.06]; I(2) = 97%), and only 1 found a shorter time to resolution of delirium using quetiapine (1.0 [confidence interval, 0.5-3.0] vs 4.5 [confidence interval, 2.0-7.0] days; P = .001). Conclusion: The use of antipsychotics for surgical ICU patients and dexmedetomidine for mechanically ventilated patients as a preventive strategy may reduce the prevalence of delirium in the ICU. None of the studied agents that were used for delirium treatment improved major clinical outcome, including mortality. | |
dc.identifier.citation | Serafim RB, Bozza FA, Soares M, do Brasil PE, Tura BR, Ely EW, Salluh JI. Pharmacologic prevention and treatment of delirium in intensive care patients: A systematic review. J Crit Care. 2015 Aug;30(4):799-807. doi: 10.1016/j.jcrc.2015.04.005. Epub 2015 Apr 17. PMID: 25957498 | |
dc.identifier.other | DOI: 10.1016/j.jcrc.2015.04.005 | |
dc.identifier.uri | https://dspace.inc.saude.gov.br/handle/123456789/374 | |
dc.language.iso | en | |
dc.publisher | Journal of Critical Care | |
dc.subject | Surgical | en |
dc.subject | Prevention | en |
dc.subject | ICU | en |
dc.subject | Delirium | en |
dc.subject.mesh | Treatment Outcome | en |
dc.subject.mesh | Rivastigmine / therapeutic use | en |
dc.subject.mesh | Risperidone / therapeutic use | en |
dc.subject.mesh | Respiration, Artificial / statistics & numerical data | en |
dc.subject.mesh | Quetiapine Fumarate / therapeutic use | en |
dc.subject.mesh | Postoperative Complications / prevention & control | en |
dc.subject.mesh | Postoperative Complications / drug therapy | en |
dc.subject.mesh | Neuroprotective Agents / therapeutic use | en |
dc.subject.mesh | Length of Stay / statistics & numerical data | en |
dc.subject.mesh | Intensive Care Units | en |
dc.subject.mesh | Hypnotics and Sedatives / therapeutic use | en |
dc.subject.mesh | Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use | en |
dc.subject.mesh | Humans | en |
dc.subject.mesh | Haloperidol / therapeutic use | en |
dc.subject.mesh | Dexmedetomidine / therapeutic use | en |
dc.subject.mesh | Delirium / prevention & control | en |
dc.subject.mesh | Delirium / drug therapy | en |
dc.subject.mesh | Critical Illness | en |
dc.subject.mesh | Critical Care | en |
dc.subject.mesh | Antipsychotic Agents / therapeutic use | en |
dc.title | Pharmacologic prevention and treatment of delirium in intensive care patients: A systematic review | |
dc.type | Article |