Cochrane · systematic review · CD009783
Interventions for preventing intensive care unit delirium in adults
Herling, SF, Greve, IE, Vasilevskis, EE, et al. · Cochrane Database of Systematic Reviews · 2018 · Cochrane Library
Emergency and Critical CareAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
15
current version
GRADE rated
13
No studies
2
Included studies
NR
No studies 2 · 13.3%Ungraded 0 · 0%Very low 7 · 46.7%Low 0 · 0%Moderate 4 · 26.7%High 2 · 13.3%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Haloperidol compared to placebo for preventing intensive care unit delirium
Population: critically ill patients 18 years or older demanding mechanical ventilation within the first 72 hours (Page 2013) or anticipated needing ICU admission at least two days (Van Den Boogard 2018).
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
The event rate of intensive care delirium within 28 days. Haloperidol vs placebo | RR 1.01 [0.87, 1.17] | 1 study · 1439 participants | Moderate Downgraded: imprecision, indirectness |
In‐hospital mortality within 28 days. Haloperidol vs placebo | RR 0.98 [0.8, 1.22] | 2 studies · 1580 participants | Moderate Downgraded: imprecision, indirectness |
Number of delirium ‐ and coma‐free days (within 28 days) measured by CAM‐ICU or ICDSC Haloperidol vs placebo | no estimate extracted | 2 studies · 1580 participants | Moderate Downgraded: imprecision, indirectness |
Ventilator‐free days (within the first 28 days) Haloperidol vs placebo | no estimate extracted | 1 study · 1439 participants | High |
Length of ICU stay (days) Haloperidol vs placebo | no estimate extracted | 2 studies · 1580 participants | High |
Cognitive impairment Haloperidol vs placebo | no estimate extracted | NR | No studies |
Adverse events Haloperidol vs placebo | no estimate extracted | 2 studies · 1580 participants | Moderate Downgraded: imprecision, indirectness |
Physical and cognitive therapy compared to standard care for preventing intensive care unit delirium
Population: critically ill patients 18 years or older treated for respiratory failure or septic or both, cardiogenic or haemorrhagic shock who resided within 120 miles of the city of hospital.
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
The event rate of ICU delirium measured by the CAM‐ICU Physical and cognitive therapy vs standard care | no estimate extracted | NR | No studies |
In‐hospital mortality at 30 days or at the longest Physical and cognitive therapy vs standard care | RR 0.94 [0.4, 2.2] | 1 study · 65 participants | Very low Downgraded: imprecision |
Number of delirium‐ and coma‐free days (within the first 30 days) measured by the CAM‐ICU Physical and cognitive therapy vs standard care | no estimate extracted | 1 study · 65 participants | Very low Downgraded: imprecision |
Ventilator‐free days (within the first 30 days) Physical and cognitive therapy vs standard care | no estimate extracted | 1 study · 65 participants | Very low Downgraded: imprecision |
Length of ICU stay (days) Physical and cognitive therapy vs standard care | MD 1.23 | 1 study · 65 participants | Very low Downgraded: imprecision |
Cognitive functioning a): Global functioning (MMSE score 0 ‐ 30, higher score indicating better cognitive function) Physical and cognitive therapy vs standard care | no estimate extracted | 1 study · 30 participants | Very low Downgraded: imprecision |
Cognitive functioning b) Executve functioning (DEX score) (scores range from 0 to 80. Lower scores indicate better functioning) (DEX) Physical and cognitive therapy vs standard care | no estimate extracted | 1 study · 30 participants | Very low Downgraded: imprecision |
Adverse events Physical and cognitive therapy vs standard care | no estimate extracted | 1 study · 65 participants | Very low Downgraded: imprecision |