SynthesisCritical care (London, England)2025
A systematic meta-review of interventions to prevent and manage delirium in the Intensive Care Unit: Part 2 - Non-pharmacological and multicomponent interventions.
Synthesis in Critical care (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 12 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
12 citing papers in PubMed, 1 synthesis or guideline 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
- Critical care delirium: prevention, identification and management: a narrative review.Anaesthesia · 2026Review
- Burden of and risk factors for neurological complications in critical illness.Intensive care medicine · 2026Review
- Autoimmune Encephalitis in Acute Care-Pathology, Diagnosis, and Management.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2026Review
- ICU Delirium as a Failure of Predictive Synchronization: A Two-Agent Active Inference Model.Entropy (Basel, Switzerland) · 2026Article
- The Ethical Tightrope of Physical and Environmental Restraint in ICU: A Balancing Act.Nursing in critical care · 2026Article
- Postoperative outcomes in older patients with postoperative delirium in the UK: SNAP-3, a snapshot observational study.British journal of anaesthesia · 2026Observational
- Clinical Outcomes and Mortality Following Delirium: A Five-Year Follow-Up Study on Hospitalized Patients.Journal of clinical medicine · 2026Article
- What does language matter? Adopting culturally relevant family-administered delirium assessment tools in the ICU.Intensive care medicine · 2026Article
- Correction: 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) · 2026Article
- Knowledge, Attitudes, and Self‑Reported Practices Regarding Sleep‑Focused Delirium Prevention Among ICU Professionals: A Multicenter Survey in Jiangxi, China.Nature and science of sleep · 2026Article
- Early mobilization in neurocritical care as a threshold-regulated intervention: a narrative review of mechanistic integration and implications for neurological recovery and physiological stability.Frontiers in neurology · 2026Review
Corrections and comments
- Erratum issued
Authors and funding
7 authors.
Funding
Abstract
backgroundIntensive Care Unit (ICU) delirium is a multifactorial syndrome associated with prolonged hospitalisation, increased morbidity and mortality, cognitive decline, and higher healthcare costs. Prevention and management of delirium have to date included both pharmacological and non-pharmacological interventions. Many of these interventions have been combined in systematic reviews. This systematic meta-review (Part 2) reviews, details and analyses non-pharmacological and multicomponent interventions to prevent and manage ICU delirium.
methodsA comprehensive search was conducted across eight databases (MEDLINE, Embase, Cochrane Database of Systematic Reviews, Scopus, CINAHL, PsycINFO and Web of Science) from their inception until 8th August 2025. Eligible reviews included critically ill adults in ICU settings and examined the effectiveness of non-pharmacological and multi-component interventions on delirium occurrence, mortality, ICU and hospital length of stay (LOS) and other core outcomes. Reviews were assessed for quality using a framework of methodological interpretation of review conduct and reporting.
resultsThirty-two systematic review and meta-analyses including 335 single studies assessing 16 non-pharmacological interventions were included. The ABCDEF bundle and other multicomponent non-pharmacological interventions and early mobilization significantly reduced delirium incidence and duration. Family participation in care was also reported to reduce delirium incidence. Mortality benefits were reported in studies of multicomponent non-pharmacological interventions. The evidence was inconsistent and often of low quality.
conclusionsWhile some non-pharmacological interventions (multi-component care packages, early mobilization and family-based interventions) show potential to reduce delirium occurrence and duration, multicomponent strategies, particularly those including early mobilization and family participation, appear more effective.
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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.