SynthesisIntensive care medicine2021
Pharmacological and non-pharmacological interventions to prevent delirium in critically ill patients: a systematic review and network meta-analysis.
Synthesis in Intensive care medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 71 papers, 14 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
71 citing papers in PubMed, 14 syntheses or guidelines pooled it, 136 citations in OpenAlex.
- A network meta-analysis of intensive nursing interventions for delirium in ICU patients.Medicine · 2026Pooled it
- Effectiveness and safety of melatoninergic agonists in preventing delirium in the ICU: an updated dose‒response meta-analysis of randomized controlled trials.Critical care (London, England) · 2026Pooled it
- A comprehensive review and meta-analysis on the safety and efficacy of esketamine for emerging delirium in elderly patients.Frontiers in medicine · 2026Pooled it
- Effects of music therapy on delirium, clinical outcomes, and psychological and sleep outcomes in adult ICU patients: a systematic review and meta-analysis.Frontiers in medicine · 2026Pooled it
- Comparative effectiveness of non-pharmacological interventions on health-related quality of life in ICU patients: a network meta-analysis.Frontiers in medicine · 2026Pooled it
- Multicomponent non-pharmacological interventions for preventing delirium in critically ill patients: a systematic review and meta-analysis of randomized controlled trials.Frontiers in neuroscience · 2026Pooled 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
- Effect of Dexmedetomidine Dose on Reducing Delirium in Adults: An Indirect Comparison of Controlled Trials.Medical science monitor : international medical journal of experimental and clinical research · 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
- Exercise therapy for the treatment of delirium in the intensive care unit.The Cochrane database of systematic reviews · 2025Pooled it
- The Effects of Dexmedetomidine on Postoperative Delirium in Adult Cardiac Surgical Patients: A Bayesian Meta-Analysis and Trial Sequential Analysis.Acta anaesthesiologica Scandinavica · 2025Pooled it
- Comparison of the effects of remimazolam and propofol on postoperative delirium in elderly surgical patients: a meta-analysis.BMC anesthesiology · 2025Pooled it
- Application of light in delirium: a bibliometric analysis.Frontiers in neurology · 2025Pooled it
- Comparative efficacy and safety of 20 intravenous pharmaceutical intervention for prevention of etomidate-induced myoclonus: a systematic review and Bayesian network meta-analysis.Frontiers in pharmacology · 2024Pooled it
- Trial
- Intraoperative oxygen concentration and postoperative delirium in elderly patients undergoing major abdominal surgery: a prospective randomized controlled clinical trial.International journal of colorectal disease · 2025Trial
- Trial
- Long-term outcomes with haloperidol versus placebo in acutely admitted adult ICU patients with delirium.Intensive care medicine · 2024Trial
- Identifying research priorities in adult intensive care in the United Kingdom: Results from a James Lind Alliance priority setting partnership.Journal of the Intensive Care Society · 2026Article
- Critical care delirium: prevention, identification and management: a narrative review.Anaesthesia · 2026Review
11 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 9 institutions in 4 countries.
Funding
Abstract
purposeTo compare the effects of prevention interventions on delirium occurrence in critically ill adults.
methodsMEDLINE, Embase, PsychINFO, CINAHL, Web of Science, Cochrane Library, Prospero, and WHO international clinical trial registry were searched from inception to April 8, 2021. Randomized controlled trials of pharmacological, sedation, non-pharmacological, and multi-component interventions enrolling adult critically ill patients were included. We performed conventional pairwise meta-analyses, NMA within Bayesian random effects modeling, and determined surface under the cumulative ranking curve values and mean rank. Reviewer pairs independently extracted data, assessed bias using Cochrane Risk of Bias tool and evidence certainty with GRADE. The primary outcome was delirium occurrence; secondary outcomes were durations of delirium and mechanical ventilation, length of stay, mortality, and adverse effects.
resultsEighty trials met eligibility criteria: 67.5% pharmacological, 31.3% non-pharmacological and 1.2% mixed pharmacological and non-pharmacological interventions. For delirium occurrence, 11 pharmacological interventions (38 trials, N = 11,993) connected to the evidence network. Compared to placebo, only dexmedetomidine (21/22 alpha
conclusionCompared to placebo and benzodiazepines, we found dexmedetomidine likely reduced the occurrence of delirium in critically ill adults. Compared to benzodiazepines, sedation-minimization strategies may also reduce delirium occurrence, but the evidence is uncertain.
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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.