SynthesisBMJ open2019
Pharmacological interventions for prevention and management of delirium in intensive care patients: a systematic overview of reviews and meta-analyses.
Synthesis in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- A systematic meta-review of interventions to prevent and manage delirium in the Intensive Care Unit: Part 1 - Pharmacological interventions.Critical care (London, England) · 2025Pooled it
- A systematic meta-review of interventions to prevent and manage delirium in the Intensive Care Unit: Part 2 - Non-pharmacological and multicomponent interventions.Critical care (London, England) · 2025Pooled it
- The effect of non-pharmacologic strategies on prevention or management of intensive care unit delirium: a systematic review.F1000Research · 2020Pooled it
- Trial
- Olanzapine for the Prevention and Treatment of ICU Delirium: Protocol for a Systematic Review With Meta-Analysis.Acta anaesthesiologica Scandinavica · 2026Article
- Barriers and facilitators to the delivery of delirium care in intensive care units: an analysis informed by the Theoretical Domains Framework.Anaesthesia · 2026Article
- Nursing delirium management to promoting critically ill patients' safety: an umbrella review.Acute and critical care · 2025Article
- The implementation and evaluation of a family-led novel intervention for delirium prevention and management in adult critically ill patients: A mixed-methods pilot study.Nursing in critical care · 2025Article
- Article
- Psychological interventions for patients with delirium in intensive care: A scoping review protocol.PloS one · 2024Article
- Delirium and sleep quality in the intensive care unit: the role of melatonin.Critical care science · 2024Article
- Prophylactic Melatonin for Delirium in Intensive Care Unit: An Updated Systematic Review and Meta-analysis of Randomized Controlled Trials.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2023Review
- The occurrence of delirium diagnosis among youth hospitalizations in the United States: A Kids' Inpatient Database analysis.Acta psychiatrica Scandinavica · 2023Article
- Postoperative Delirium in Neurosurgical Patients: Recent Insights into the Pathogenesis.Brain sciences · 2022Review
- How We Prevent and Treat Delirium in the ICU.Chest · 2021Review
- Is "behavioural disturbance" a clinically more useful concept than "delirium" for trials in intensive care medicine?Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine · 2021Article
- Dementia prevention, intervention, and care: 2020 report of the Lancet Commission.Lancet (London, England) · 2020Review
- Development and validation of delirium prediction model for critically ill adults parameterized to ICU admission acuity.PloS one · 2020Article
- Current controversies and future perspectives on treatment of intensive care unit delirium in adults.World journal of critical care medicine · 2019Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesWe assessed the evidence from reviews and meta-analyses of randomised clinical trials on the effects of pharmacological prevention and management of delirium in intensive care unit (ICU) patients.
methodsWe searched for reviews in July 2017 in: Cochrane Library, MEDLINE, Embase, Science Citation Index, BIOSIS Previews, CINAHL and LILACS. We assessed whether reviews were systematic according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and assessed the methodological quality using ROBIS. OUTCOME MEASURES: Primary outcomes: all-cause mortality, serious adverse events, prevention of delirium and management of delirium. SECONDARY OUTCOMES: quality of life; non-serious adverse events and cognitive function.
resultsWe included 378 reviews: 369 narrative reviews, eight semisystematic reviews which failed on a maximum of two arbitrary PRISMA criteria and one systematic review fulfilling all 27 PRISMA criteria. For the prevention of delirium, we identified the one systematic review and eight semisystematic reviews all assessing the effects of alpha-2-agonists. None found evidence of a reduction of mortality (systematic review RR 0.99, 95% CI 0.79 to 1.24). The systematic review and three semisystematic reviews found no evidence of an effect for the prevention of delirium (systematic review RR 0.85, 0.63 to 1.14). Conversely, four semisystematic reviews found a beneficial effect. Serious adverse events, quality of life, non-serious adverse events and cognitive function were not assessed. We did not identify any systematic or semisystematic reviews addressing other pharmacological interventions for the prevention of delirium. For the management of manifest delirium, we did not identify any systematic or semisystematic review assessing any pharmacological agents.
conclusionBased on systematic reviews, the evidence for the use of pharmacological interventions for prevention or management of delirium is poor or sparse. A systematic review with low risk of bias assessing the effects of pharmacological prevention of delirium and management of manifest delirium in ICU patients is urgently needed. PROSPERO REGISTRATION NUMBER: CRD42016046628.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.