ReviewCurrent neuropharmacology2021
Challenges of Delirium Management in Patients with Traumatic Brain Injury: From Pathophysiology to Clinical Practice.
Review in Current neuropharmacology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis 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
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 42 citations in OpenAlex.
- Prevention and treatment of traumatic brain injury-related delirium: a systematic review.Journal of neurology · 2023Pooled it
- A randomized controlled trial investigating the impact of early goal-directed sedation dominated by dexmedetomidine on cerebral oxygen metabolism and inflammatory mediators in patients with severe brain injury.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025Trial
- Effect of mannitol on postoperative delirium in patients undergoing coronary artery bypass graft: a randomised controlled trial.Open heart · 2024Trial
- Effect Evaluation of Dexmedetomidine Intravenous Anesthesia on Postoperative Agitation in Patients with Craniocerebral Injury by Magnetic Resonance Imaging Based on Sparse Reconstruction Algorithm.Contrast media & molecular imaging · 2022Trial
- Updates in Management of Acute Disorders of Consciousness After Traumatic Injury.Brain sciences · 2026Review
- Glymphatic dysfunction: a unifying hypothesis for delirium.Nature reviews. Neurology · 2026Review
- Predictive Modeling of Preoperative Sleep Disorder Risk in Older Adults by Using Data From Wearable Monitoring Devices: Prospective Cohort Study.JMIR formative research · 2026Article
- Mechanical Ventilation Suppresses Glymphatic Function in Parallel with Delirium-Like Symptoms in Mice.bioRxiv : the preprint server for biology · 2025Article
- Delirium after major trauma critical care and the association with recovery at 12 months.Trauma (London, England) · 2025Article
- Association between the glucose-to-potassium ratio and delirium in critically ill ICU patients: a retrospective study.Scientific reports · 2025Article
- Impact of Delirium-Related Stress, Self-Efficacy, Person-Centred Care on Delirium Nursing Performance Among Nurses in Trauma Intensive Care Units: A Cross-Sectional Descriptive Survey Study.Healthcare (Basel, Switzerland) · 2025Article
- Gallic acid alleviates ferroptosis by negatively regulating APOC3 and improves nerve function deficit caused by traumatic brain injury.Scientific reports · 2025Article
- Article
- Beyond the Lungs: Extrapulmonary Effects of Non-Invasive and Invasive Ventilation Strategies.Journal of clinical medicine · 2025Review
- Enhancing Delirium Prediction and Prevention in Elderly Patients Through Machine Learning-Based Analysis.Sultan Qaboos University medical journal · 2025Article
- Article
- Identifying excessive chronic alcohol use with phosphatidylethanol in patients with suspected severe injury-results from the IDART study.Alcohol and alcoholism (Oxford, Oxfordshire) · 2024Article
- Analysis of the correlation and influencing factors between delirium, sleep, self-efficacy, anxiety, and depression in patients with traumatic brain injury: a cohort study.Frontiers in neuroscience · 2024Article
- The establishment and validation of a prediction model for traumatic intracranial injury patients: a reliable nomogram.Frontiers in neurology · 2023Article
- The neuroprotective effect of dexmedetomidine and its mechanism.Frontiers in pharmacology · 2022Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 2 institutions in 1 country.
Funding
Abstract
Traumatic brain injury (TBI) can initiate a very complex disease of the central nervous system (CNS), starting with the primary pathology of the inciting trauma and subsequent inflammatory and CNS tissue response. Delirium has long been regarded as an almost inevitable consequence of moderate to severe TBI, but more recently has been recognized as an organ dysfunction syndrome with potentially mitigating interventions. The diagnosis of delirium is independently associated with prolonged hospitalization, increased mortality and worse cognitive outcome across critically ill populations. Investigation of the unique problems and management challenges of TBI patients is needed to reduce the burden of delirium in this population. In this narrative review, possible etiologic mechanisms behind post-traumatic delirium are discussed, including primary injury to structures mediating arousal and attention and secondary injury due to progressive inflammatory destruction of the brain parenchyma. Other potential etiologic contributors include dysregulation of neurotransmission due to intravenous sedatives, seizures, organ failure, sleep cycle disruption or other delirium risk factors. Delirium screening can be accomplished in TBI patients and the presence of delirium portends worse outcomes. There is evidence that multi-component care bundles including an analgesia-prioritized sedation algorithm, regular spontaneous awakening and breathing trials, protocolized delirium assessment, early mobility and family engagement can reduce the burden of ICU delirium. The aim of this review is to summarize the approach to delirium in TBI patients with an emphasis on pathogenesis and management. Emerging CNS-active drug therapies that show promise in preclinical studies are highlighted.
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Registered trials
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.