Cochrane · systematic review · CD011749
Pharmacological interventions for the treatment of delirium in critically ill adults
Burry, L, Hutton, B, Williamson, DR, et al. · Cochrane Database of Systematic Reviews · 2019 · 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
31
current version
GRADE rated
26
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 5 · 16.1%Very low 4 · 12.9%Low 4 · 12.9%Moderate 16 · 51.6%High 2 · 6.5%
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
Duration of delirium
Population: critically ill adults with confirmed or at high risk of delirium
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Typical antipsychotic vs placebo | no estimate extracted | 4 studies · 608 participants | High |
Atypical antipsychotic vs placebo | no estimate extracted | 4 studies · 500 participants | Moderate Downgraded: inconsistency |
Statin (HMG‐CoA) vs placebo | no estimate extracted | 2 studies · 414 participants | Moderate Downgraded: imprecision |
Alpha2 agonist vs placebo | no estimate extracted | 1 study · 71 participants | Moderate Downgraded: imprecision |
Cholinesterase inhibitor vs placebo | no estimate extracted | 1 study · 104 participants | Moderate Downgraded: imprecision |
Opioid vs placebo | no estimate extracted | 0 studies · 0 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Days with coma
Population: critically ill adult with confirmed or at high risk of delirium
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Typical antipsychotic vs placebo | no estimate extracted | 3 studies · 588 participants | Low Downgraded: imprecision, inconsistency |
Atypical antipsychotic vs placebo | no estimate extracted | 2 studies · 440 participants | Moderate Downgraded: imprecision |
Statin (HMG‐CoA) vs placebo | no estimate extracted | 2 studies · 414 participants | Moderate Downgraded: imprecision |
Duration of mechanical ventilation
Population: critically ill adult with confirmed or at high risk of delirium
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Typical antipsychotics vs placebo | no estimate extracted | 3 studies · 515 participants | Moderate Downgraded: imprecision |
Atypical antipsychotics vs placebo | no estimate extracted | 3 studies · 476 participants | Moderate Downgraded: imprecision |
Statin (HMG‐CoA)vs placebo | no estimate extracted | 1 study · 272 participants | Moderate Downgraded: imprecision |
Alpha2 agonist vs placebo | no estimate extracted | 1 study · 71 participants | Moderate Downgraded: imprecision |
Opioid vs placebo | no estimate extracted | 0 studies · 0 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Length of ICU stay
Population: critically ill adult with confirmed or at high risk of delirium
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Typical antipsychotic vs placebo | no estimate extracted | 4 studies · 618 participants | Moderate Downgraded: imprecision |
Atypical antipsychotic vs placebo | no estimate extracted | 4 studies · 577 participants | High |
Statin (HMG‐CoA) vs placebo | no estimate extracted | 1 study · 272 participants | Low Downgraded: risk of bias, imprecision, indirectness |
Alpha2 agonist vs placebo | no estimate extracted | 1 study · 71 participants | Low Downgraded: risk of bias, imprecision, indirectness |
Cholinesterase inhibitor vs placebo | no estimate extracted | 1 study · 104 participants | Moderate Downgraded: imprecision |
Opioid vs placebo | no estimate extracted | 0 studies · 0 participants | Very low Downgraded: imprecision |
Length of hospital stay
Population: critically ill adult with confirmed or at high risk of delirium
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Typical AP vs placebo | no estimate extracted | 2 studies · 479 participants | Low Downgraded: imprecision, inconsistency |
Atypical AP vs placebo | no estimate extracted | 3 studies · 511 participants | Moderate Downgraded: imprecision |
Statin (HMG‐CoA)vs placebo | no estimate extracted | 2 studies · 369 participants | Moderate Downgraded: imprecision |
Alpha2 agonistvs placebo | no estimate extracted | 1 study · 71 participants | Moderate Downgraded: risk of bias, indirectness |
Cholinesterase Inhibitor vs placebo | no estimate extracted | 1 study · 104 participants | Moderate Downgraded: risk of bias, indirectness |
Opioid vs placebo | no estimate extracted | 0 studies · 0 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
QTc prolongation
Population: critically ill adult with confirmed or at high risk of delirium
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Typical antipsychotic vs placebo | no estimate extracted | 4 studies · 656 participants | Ungraded |
Atypical antipsychotic vs placebo | no estimate extracted | 4 studies · 577 participants | Ungraded |
Typical antipsychoticvs atypical antipsychotic | no estimate extracted | 2 studies · 447 participants | Ungraded |
Alpha2 agonist vs typical antipsychotic | no estimate extracted | 1 study · 20 participants | Ungraded |
Alpha2 agonist vs 5HT3 inhibitor | no estimate extracted | 1 study · 64 participants | Ungraded |