Pharmacologic prevention and treatment of delirium in intensive care patients: a systematic review

dc.creatorSerafim, Rodrigo B.
dc.creatorBozza, Fernando A.
dc.creatorSoares, Marcio
dc.creatorBrasil, Pedro Emanuel A. A. do
dc.creatorTura, Bernardo R.
dc.creatorEly, E. Wesley
dc.creatorSalluh, Jorge I. F.
dc.date2019-08-21T12:18:15Z
dc.date2019-08-21T12:18:15Z
dc.date2015
dc.date.accessioned2023-09-27T00:15:18Z
dc.date.available2023-09-27T00:15:18Z
dc.identifierSERAFIM, Rodrigo B. et al. Pharmacologic prevention and treatment of delirium in intensive care patients: a systematic review. Journal of Critical Care, v. 30, n. 4, p. 799-807, Aug. 2015.
dc.identifier0883-9441
dc.identifierhttps://www.arca.fiocruz.br/handle/icict/34915
dc.identifier10.1016/j.jcrc.2015.04.005
dc.identifier.urihttps://repositorioslatinoamericanos.uchile.cl/handle/2250/8899001
dc.descriptionPurpose: 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 careunit (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, I2= 81%, P=.0013; I2=97%, Pb.001; and I2= 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]; I2= 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.description2020-08-21
dc.formatapplication/pdf
dc.languageeng
dc.publisherElsevier
dc.rightsopen access
dc.subjectDelirium
dc.subjectPrevention
dc.subjectICU
dc.subjectSurgical
dc.titlePharmacologic prevention and treatment of delirium in intensive care patients: a systematic review
dc.typeArticle


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