Delirium: Effectiveness of Systematic Interventions

Abstract

The purpose of this paper was to review evidence related to the effectiveness of systematic interventions in preventing or detecting and treating delirium. The review process involved a systematic search of the literature on each topic, assessment of the validity of the studies retrieved and examination of their results. The literature search identified 10 studies on prevention and 7 studies on detection and treatment. A broad spectrum of systematic interventions appeared to be modestly effective in preventing delirium in young and old surgical patients but not elderly medical patients. Systematic detection and treatment programs and special nursing care appeared to add large benefits to traditional medical care in young and old surgical patients and modest benefits in elderly medical patients; however, it seemed that the more precise the target of the detection and treatment program, the greater the benefit.

Delirium: Guidelines for general hospitals

“…Searches on systematic reviews identified 3178 papers, including 2099 articles in Medline, 334 articles in PsychINFO, 724 articles in the Web of Knowledge, and 21 articles in the Cochrane Library. Sixteen systematic reviews [7,12,[30][31][32][33][34][35][36][37][38][39][40][41][42][43] were found in Medline, one in the Web of Knowledge [44], one in EMBASE, [45] and one in the Cochrane Library [46]. No additional systematic review was found in PsychINFO.…”

“…These interventions should be considered for all delirious patients. Specific therapeutic interventions and nursedirected care seem to have a beneficial effect on the evolution of delirium in surgical [7,44,47] and medical [5,51,88,89,114] inpatients.…”

Delirium in the first days of acute stroke

“…This justifies a systematic approach to its detection, prevention, pharmacological and non-pharmacological management [23,24].…”

The effects of a tailored intensive care unit delirium prevention protocol: A randomized controlled trial

“…The risk factors encompass primary risk factors (i.e., brain damage, dementia, and cognitive impairment due to stroke) (Barr et al, 2013;Michaud et al, 2007), physical factors (i.e., visual and auditory disorders, fluid and electrolyte imbalance, metabolism disorders, emergency hospitalization, hypoperfusion, pain, fracture, hypertension, alcoholism, high severity of illness at admission, and infection) (Barr et al, 2013;Cole, 1999;Sendelbach et al, 2009), and frequently, combinations of several factors (i.e., combination of sleep deprivation, use of a restraint, and exposure to noise) (Michaud et al, 2007). Therefore, a multidisciplinary and multi-component intervention approach is recommended for delirium prevention (Boorsma et al, 2011;Cerejeira and Mukaetova-Ladinska, 2011;Holroyd-Leduc et al, 2010).…”