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The effect of non-pharmacologic strategies on prevention or management of intensive care unit delirium: a systematic review

Background: Post-operative delirium is a common complication among adult patients in the intensive care unit. Current literature does not support the use of pharmacologic measures to manage this condition, and several studies explore the potential for the use of non-pharmacologic methods such as ear...

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Autores principales: Cupka, Julie S, Hashemighouchani, Haleh, Lipori, Jessica, Ruppert, Matthew M., Bhaskar, Ria, Ozrazgat-Baslanti, Tezcan, Rashidi, Parisa, Bihorac, Azra
Formato: Online Artículo Texto
Lenguaje:English
Publicado: F1000 Research Limited 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9449425/
https://www.ncbi.nlm.nih.gov/pubmed/36110837
http://dx.doi.org/10.12688/f1000research.25769.3
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author Cupka, Julie S
Hashemighouchani, Haleh
Lipori, Jessica
Ruppert, Matthew M.
Bhaskar, Ria
Ozrazgat-Baslanti, Tezcan
Rashidi, Parisa
Bihorac, Azra
author_facet Cupka, Julie S
Hashemighouchani, Haleh
Lipori, Jessica
Ruppert, Matthew M.
Bhaskar, Ria
Ozrazgat-Baslanti, Tezcan
Rashidi, Parisa
Bihorac, Azra
author_sort Cupka, Julie S
collection PubMed
description Background: Post-operative delirium is a common complication among adult patients in the intensive care unit. Current literature does not support the use of pharmacologic measures to manage this condition, and several studies explore the potential for the use of non-pharmacologic methods such as early mobility plans or environmental modifications. The aim of this systematic review is to examine and report on recently available literature evaluating the relationship between non-pharmacologic management strategies and the reduction of delirium in the intensive care unit. Methods: Six major research databases were systematically searched for articles analyzing the efficacy of non-pharmacologic delirium interventions in the past five years. Search results were restricted to adult human patients aged 18 years or older in the intensive care unit setting, excluding terminally ill subjects and withdrawal-related delirium. Following title, abstract, and full text review, 27 articles fulfilled the inclusion criteria and are included in this report. Results: The 27 reviewed articles consist of 12 interventions with a single-component investigational approach, and 15 with multi-component bundled protocols. Delirium incidence was the most commonly assessed outcome followed by duration. Family visitation was the most effective individual intervention while mobility interventions were the least effective. Two of the three family studies significantly reduced delirium incidence, while one in five mobility studies did the same. Multi-component bundle approaches were the most effective of all; of the reviewed studies, eight of 11 bundles significantly improved delirium incidence and seven of eight bundles decreased the duration of delirium. Conclusions: Multi-component, bundled interventions were more effective at managing intensive care unit delirium than those utilizing an approach with a single interventional element. Although better management of this condition suggests a decrease in resource burden and improvement in patient outcomes, comparative research should be performed to identify the importance of specific bundle elements.
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spelling pubmed-94494252022-09-14 The effect of non-pharmacologic strategies on prevention or management of intensive care unit delirium: a systematic review Cupka, Julie S Hashemighouchani, Haleh Lipori, Jessica Ruppert, Matthew M. Bhaskar, Ria Ozrazgat-Baslanti, Tezcan Rashidi, Parisa Bihorac, Azra F1000Res Systematic Review Background: Post-operative delirium is a common complication among adult patients in the intensive care unit. Current literature does not support the use of pharmacologic measures to manage this condition, and several studies explore the potential for the use of non-pharmacologic methods such as early mobility plans or environmental modifications. The aim of this systematic review is to examine and report on recently available literature evaluating the relationship between non-pharmacologic management strategies and the reduction of delirium in the intensive care unit. Methods: Six major research databases were systematically searched for articles analyzing the efficacy of non-pharmacologic delirium interventions in the past five years. Search results were restricted to adult human patients aged 18 years or older in the intensive care unit setting, excluding terminally ill subjects and withdrawal-related delirium. Following title, abstract, and full text review, 27 articles fulfilled the inclusion criteria and are included in this report. Results: The 27 reviewed articles consist of 12 interventions with a single-component investigational approach, and 15 with multi-component bundled protocols. Delirium incidence was the most commonly assessed outcome followed by duration. Family visitation was the most effective individual intervention while mobility interventions were the least effective. Two of the three family studies significantly reduced delirium incidence, while one in five mobility studies did the same. Multi-component bundle approaches were the most effective of all; of the reviewed studies, eight of 11 bundles significantly improved delirium incidence and seven of eight bundles decreased the duration of delirium. Conclusions: Multi-component, bundled interventions were more effective at managing intensive care unit delirium than those utilizing an approach with a single interventional element. Although better management of this condition suggests a decrease in resource burden and improvement in patient outcomes, comparative research should be performed to identify the importance of specific bundle elements. F1000 Research Limited 2022-06-24 /pmc/articles/PMC9449425/ /pubmed/36110837 http://dx.doi.org/10.12688/f1000research.25769.3 Text en Copyright: © 2022 Cupka JS et al. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Systematic Review
Cupka, Julie S
Hashemighouchani, Haleh
Lipori, Jessica
Ruppert, Matthew M.
Bhaskar, Ria
Ozrazgat-Baslanti, Tezcan
Rashidi, Parisa
Bihorac, Azra
The effect of non-pharmacologic strategies on prevention or management of intensive care unit delirium: a systematic review
title The effect of non-pharmacologic strategies on prevention or management of intensive care unit delirium: a systematic review
title_full The effect of non-pharmacologic strategies on prevention or management of intensive care unit delirium: a systematic review
title_fullStr The effect of non-pharmacologic strategies on prevention or management of intensive care unit delirium: a systematic review
title_full_unstemmed The effect of non-pharmacologic strategies on prevention or management of intensive care unit delirium: a systematic review
title_short The effect of non-pharmacologic strategies on prevention or management of intensive care unit delirium: a systematic review
title_sort effect of non-pharmacologic strategies on prevention or management of intensive care unit delirium: a systematic review
topic Systematic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9449425/
https://www.ncbi.nlm.nih.gov/pubmed/36110837
http://dx.doi.org/10.12688/f1000research.25769.3
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