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Melatonin intervention to prevent delirium in the intensive care units: a systematic review and meta-analysis of randomized controlled trials

OBJECTIVE: To determine the preventive effect of melatonin on delirium in the intensive care units. METHODS: We conducted a systematic search of the PubMed, Cochrane Library, Science, Embase, and CNKI databases, with retrieval dates ranging from the databases’ inception to September 2022. Controlled...

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Autores principales: Duan, Yushan, Yang, Yuan, Zhu, Weihua, Wan, Linjun, Wang, Gang, Yue, Jinxi, Bao, Qi, Shao, Jianlin, Wan, Xiaohong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10410466/
https://www.ncbi.nlm.nih.gov/pubmed/37564987
http://dx.doi.org/10.3389/fendo.2023.1191830
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author Duan, Yushan
Yang, Yuan
Zhu, Weihua
Wan, Linjun
Wang, Gang
Yue, Jinxi
Bao, Qi
Shao, Jianlin
Wan, Xiaohong
author_facet Duan, Yushan
Yang, Yuan
Zhu, Weihua
Wan, Linjun
Wang, Gang
Yue, Jinxi
Bao, Qi
Shao, Jianlin
Wan, Xiaohong
author_sort Duan, Yushan
collection PubMed
description OBJECTIVE: To determine the preventive effect of melatonin on delirium in the intensive care units. METHODS: We conducted a systematic search of the PubMed, Cochrane Library, Science, Embase, and CNKI databases, with retrieval dates ranging from the databases’ inception to September 2022. Controlled trials on melatonin and placebo for preventing delirium in the intensive care units were included. The meta-analysis was performed using Review Manager software (version 5.3) and Stata software (version 14.0). RESULTS: Six studies involving 2374 patients were included in the meta-analysis. The results of the meta-analysis showed that melatonin did not reduce the incidence of delirium in ICU patients (odds ratio [OR]: 0.71; 95% confidence interval [CI]: 0.46 to 1.12; p = 0.14). There was a strong hetero-geneity between the selected studies (I(2) = 74%). Subgroup analysis results showed that melatonin reduced the incidence of delirium in cardiovascular care unit (CCU) patients (OR: 0.52; 95% CI: 0.37 to 0.73; p=0.0001), but did not in general intensive care unit (GICU) patients (OR: 1.14; 95% CI: 0.86 to 1.50; p=0.35). In terms of the secondary outcomes, there were no significant differences in all-cause mortality (OR: 0.85; 95% CI: 0.66 to 1.09; p=0.20), length of ICU stay (mean difference [MD]: 0.33; 95% CI: -0.53 to 1.18; p=0.45), or length of hospital stay (MD: 0.51; 95% CI: -1.17 to 2.19; p=0.55). CONCLUSION: Melatonin reduced the incidence of delirium in CCU patients, but did not significantly reduce the incidence of delirium in GICU patients. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/prospero/, identifier CRD42022367665.
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spelling pubmed-104104662023-08-10 Melatonin intervention to prevent delirium in the intensive care units: a systematic review and meta-analysis of randomized controlled trials Duan, Yushan Yang, Yuan Zhu, Weihua Wan, Linjun Wang, Gang Yue, Jinxi Bao, Qi Shao, Jianlin Wan, Xiaohong Front Endocrinol (Lausanne) Endocrinology OBJECTIVE: To determine the preventive effect of melatonin on delirium in the intensive care units. METHODS: We conducted a systematic search of the PubMed, Cochrane Library, Science, Embase, and CNKI databases, with retrieval dates ranging from the databases’ inception to September 2022. Controlled trials on melatonin and placebo for preventing delirium in the intensive care units were included. The meta-analysis was performed using Review Manager software (version 5.3) and Stata software (version 14.0). RESULTS: Six studies involving 2374 patients were included in the meta-analysis. The results of the meta-analysis showed that melatonin did not reduce the incidence of delirium in ICU patients (odds ratio [OR]: 0.71; 95% confidence interval [CI]: 0.46 to 1.12; p = 0.14). There was a strong hetero-geneity between the selected studies (I(2) = 74%). Subgroup analysis results showed that melatonin reduced the incidence of delirium in cardiovascular care unit (CCU) patients (OR: 0.52; 95% CI: 0.37 to 0.73; p=0.0001), but did not in general intensive care unit (GICU) patients (OR: 1.14; 95% CI: 0.86 to 1.50; p=0.35). In terms of the secondary outcomes, there were no significant differences in all-cause mortality (OR: 0.85; 95% CI: 0.66 to 1.09; p=0.20), length of ICU stay (mean difference [MD]: 0.33; 95% CI: -0.53 to 1.18; p=0.45), or length of hospital stay (MD: 0.51; 95% CI: -1.17 to 2.19; p=0.55). CONCLUSION: Melatonin reduced the incidence of delirium in CCU patients, but did not significantly reduce the incidence of delirium in GICU patients. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/prospero/, identifier CRD42022367665. Frontiers Media S.A. 2023-07-26 /pmc/articles/PMC10410466/ /pubmed/37564987 http://dx.doi.org/10.3389/fendo.2023.1191830 Text en Copyright © 2023 Duan, Yang, Zhu, Wan, Wang, Yue, Bao, Shao and Wan https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Endocrinology
Duan, Yushan
Yang, Yuan
Zhu, Weihua
Wan, Linjun
Wang, Gang
Yue, Jinxi
Bao, Qi
Shao, Jianlin
Wan, Xiaohong
Melatonin intervention to prevent delirium in the intensive care units: a systematic review and meta-analysis of randomized controlled trials
title Melatonin intervention to prevent delirium in the intensive care units: a systematic review and meta-analysis of randomized controlled trials
title_full Melatonin intervention to prevent delirium in the intensive care units: a systematic review and meta-analysis of randomized controlled trials
title_fullStr Melatonin intervention to prevent delirium in the intensive care units: a systematic review and meta-analysis of randomized controlled trials
title_full_unstemmed Melatonin intervention to prevent delirium in the intensive care units: a systematic review and meta-analysis of randomized controlled trials
title_short Melatonin intervention to prevent delirium in the intensive care units: a systematic review and meta-analysis of randomized controlled trials
title_sort melatonin intervention to prevent delirium in the intensive care units: a systematic review and meta-analysis of randomized controlled trials
topic Endocrinology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10410466/
https://www.ncbi.nlm.nih.gov/pubmed/37564987
http://dx.doi.org/10.3389/fendo.2023.1191830
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