NICE Guideline: Evidence for pharmacological treatment of delirium

Randomised control trials for delirium: Current evidence and statistical methods

“…Two other RCTs were omitted by the authors [5,6], perhaps for similar reasons (namely, small sample size) as the NICE guideline made the same omission [8]. The remaining RCTs for treatment of delirium are adequately summarised elsewhere [7,8]. It is worth noting that, to date, the largest sample size for a placebo controlled RCT in delirium is for rivastigmine (54 rivastigmine, 50 placebo) [9].…”

Delirium postoperatorio: una consecuencia del envejecimiento poblacional

“…Al parecer la efectividad de estas medidas tendría impacto en reducir la duración y severidad del delirium, así como los días de hospitalización [111][112][113] . Aunque no tengan respaldo suficiente basado en la evidencia, diversas guías clínicas las recomiendan 114,115 . Estas medidas son: descartar una complicación quirúrgica o médica, cuidado continuo de enfermería, asegurar nutrición e hidratación, movilización precoz, asegurar patrón de ciclo sueño-vigilia y manipulación del ambiente, reorientación (reloj, calendario, recordar el espacio-tiempo), evitar cambios excesivos de personal y minimizar alteraciones sensoriales (uso de lentes ópticos y audífonos) 116 .…”

Delirium

“…25e28 However, there is limited evidence from systematic studies, controlled trials or randomized controlled trials for the treatment and management of delirium. 29 A one-page evidence-based clinical management guideline was developed as an ethical requirement for a randomized control trial 30 of treatment (Figure 1).…”

“…30,35,36 It is noteworthy that there is no placebo-controlled RCT evidence to support the use of haloperidol. 29 To date there are only three published placebo-controlled RCTs for treatment of delirium using antipsychotics, 30,35,36 only one of which took place in a general hospital setting. 37 Appropriate dosages, based on information from various RCTs, are presented in Table 3.…”