Interventions From Randomized ICU Trials Do Not Reduce Delirium Duration

Abstract

Figure 1. Meta-analysis of difference in duration of delirium. Included only studies comparing intervention (pharmacological and nonpharmacological intervention) versus placebo (or standard care).

The author replies

“…The methods used in our article are state-of-the-art, and the conclusions we make are data-driven and balanced. I feel that the additional insights offered by Gusmao-Flores et al (1), rather than invalidating the conclusions we make, should be considered in the context of the many limitations we already highlight in our article and that support the primary take-home message of our article: that additional large, controlled studies are needed to establish the relationship between delirium duration and short-term mortality in critically ill adults.…”

“…O n behalf of my coauthors, I thank Gusmao-Flores et al (1) for their interest in our meta-regression analysis (2) that sought to explore whether ICU interventions, both pharmacologic and nonpharmacologic, that are more effective at reducing delirium duration are associated with a reduction in short-term mortality. In their letter, they suggest that for the trials we identified where a pharmacologic intervention was evaluated, we should have included only those studies comparing a medication with a placebo because "the positive results in this meta-analysis can only express the impact in inducing delirium caused by some of these drugs (i.e., morphine and midazolam)."…”