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Intensive Care Medicine

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01-01-2019 | Systematic Review

The effectiveness of non-pharmacological interventions in reducing the incidence and duration of delirium in critically ill patients: a systematic review and meta-analysis

Authors: Leona Bannon, Jennifer McGaughey, Rejina Verghis, Mike Clarke, Daniel F. McAuley, Bronagh Blackwood

Published in: Intensive Care Medicine | Issue 1/2019

Abstract

Purpose

To evaluate the effect of non-pharmacological interventions versus standard care on incidence and duration of delirium in critically ill patients.

Methods

We searched electronic and grey literature for randomised clinical trials up to March 2018. Two reviewers independently screened, selected and extracted data. Meta-analysis was undertaken using random effects modelling.

Results

We identified 15 trials (2812 participants). Eleven trials reported incidence of delirium. Pooled data from four trials of bright light therapy showed no significant effect between groups (n = 829 participants, RR 0.45, 99% CI 0.10–2.13, P = 0.19, very low quality evidence). Seven trials of various individual interventions also failed to report any significant effects. A total of eight trials reported duration of delirium. Pooled data from two trials of multicomponent physical therapy showed no significant effect [n = 404 participants, MD (days) − 0.65, 99% CI − 2.73 to 1.44, P = 0.42, low quality of evidence]. Four trials of various individual interventions also reported no significant effects. A trial of family voice reorientation showed a beneficial effect [n = 30, MD (days) − 1.30, 99% CI − 2.41 to − 0.19, P = 0.003, very low quality evidence].

Conclusions

Current evidence does not support the use of non-pharmacological interventions in reducing incidence and duration of delirium in critically ill patients. Future research should consider well-designed and well-described multicomponent interventions and include adequately defined outcome measures.

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Title: The effectiveness of non-pharmacological interventions in reducing the incidence and duration of delirium in critically ill patients: a systematic review and meta-analysis
Authors: Leona Bannon
Jennifer McGaughey
Rejina Verghis
Mike Clarke
Daniel F. McAuley
Bronagh Blackwood
Publication date: 01-01-2019
Publisher: Springer Berlin Heidelberg
Published in: Intensive Care Medicine / Issue 1/2019
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-018-5452-x

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

The effectiveness of non-pharmacological interventions in reducing the incidence and duration of delirium in critically ill patients: a systematic review and meta-analysis

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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