Pharmacological interventions for delirium in intensive care patients: a protocol for an overview of reviews

Barbateskovic, Marija; Larsen, Laura Krone; Collet, Marie Oxenbøll; Jakobsen, Janus Christian; Perner, Anders; Wetterslev, Jørn

doi:10.1186/s13643-016-0391-5

Cited by 21 publications

(17 citation statements)

References 91 publications

(99 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We conducted this systematic overview of reviews with a registered (PROSPERO CRD42016046628) and published protocol,36 in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) (Electronic supplementary material (ESM), table 1). We used the systematic review methods principles outlined in the Cochrane Handbook37 and the recommendations given by Robinson et al 38…”

Section: Methodsmentioning

confidence: 99%

Pharmacological interventions for prevention and management of delirium in intensive care patients: a systematic overview of reviews and meta-analyses

et al. 2019

Self Cite

View full text Add to dashboard Cite

ObjectivesWe assessed the evidence from reviews and meta-analyses of randomised clinical trials on the effects of pharmacological prevention and management of delirium in intensive care unit (ICU) patients.MethodsWe searched for reviews in July 2017 in: Cochrane Library, MEDLINE, Embase, Science Citation Index, BIOSIS Previews, CINAHL and LILACS. We assessed whether reviews were systematic according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and assessed the methodological quality using ROBIS.Outcome measuresPrimary outcomes: all-cause mortality, serious adverse events, prevention of delirium and management of delirium. Secondary outcomes: quality of life; non-serious adverse events and cognitive function.ResultsWe included 378 reviews: 369 narrative reviews, eight semisystematic reviews which failed on a maximum of two arbitrary PRISMA criteria and one systematic review fulfilling all 27 PRISMA criteria. For the prevention of delirium, we identified the one systematic review and eight semisystematic reviews all assessing the effects of alpha-2-agonists. None found evidence of a reduction of mortality (systematic review RR 0.99, 95% CI 0.79 to 1.24). The systematic review and three semisystematic reviews found no evidence of an effect for the prevention of delirium (systematic review RR 0.85, 0.63 to 1.14). Conversely, four semisystematic reviews found a beneficial effect. Serious adverse events, quality of life, non-serious adverse events and cognitive function were not assessed. We did not identify any systematic or semisystematic reviews addressing other pharmacological interventions for the prevention of delirium. For the management of manifest delirium, we did not identify any systematic or semisystematic review assessing any pharmacological agents.ConclusionBased on systematic reviews, the evidence for the use of pharmacological interventions for prevention or management of delirium is poor or sparse. A systematic review with low risk of bias assessing the effects of pharmacological prevention of delirium and management of manifest delirium in ICU patients is urgently needed.PROSPERO registration numberCRD42016046628.

show abstract

Section: Methodsmentioning

confidence: 99%

Pharmacological interventions for prevention and management of delirium in intensive care patients: a systematic overview of reviews and meta-analyses

et al. 2019

Self Cite

View full text Add to dashboard Cite

show abstract

“…85 86 The method has previously been applied by our group in systematic reviews with meta-analysis on a wide range of healthcare topics. [87][88][89][90][91][92][93][94] A PRISMA-P checklist file is attached (online supplementary additional file 1).…”

Section: Methods and Analysismentioning

confidence: 99%

Effects of adding adjunctive hyperbaric oxygen therapy to standard wound care for diabetic foot ulcers: a protocol for a systematic review with meta-analysis and trial sequential analysis

et al. 2020

View full text Add to dashboard Cite

IntroductionDiabetic foot ulcer represents a major health problem globally. Preliminary studies have indicated that systemic treatment of diabetic foot ulcer patients with hyperbaric oxygen therapy have beneficial effects on wound healing, risk of amputation, glycaemic control, atherosclerosis, inflammatory markers and other clinical and laboratory parameters. This protocol for a systematic review aims at identifying the beneficial and harmful effects of adding hyperbaric oxygen therapy to standard wound care for diabetic foot ulcers.Methods and analysisThis protocol was performed following the recommendations of the Cochrane Collaboration and the eight-step assessment procedure suggested by Jakobsen and colleagues. We plan to include all relevant randomised clinical trials assessing the effects of hyperbaric oxygen therapy in the treatment of diabetic foot ulcer versus any control group with any intervention defined as standard wound care or similar, together with sham interventions. Our primary outcome will be: all-cause mortality, serious adverse events and quality of life. Our secondary outcomes will be: healing of index wound, major amputation and wound infection. Any eligible trial will be assessed and classified as either high risk of bias or low risk of bias, and our conclusions will be based on trials with low risk of bias. The analyses of the extracted data will be performed using Review Manager 5 and Trial Sequential Analysis. For both our primary and secondary outcomes, we will create a ‘Summary of Findings’ table and use GRADE (Grading of Recommendations Assessment, Development and Evaluation) assessment to assess the quality of the evidence.Ethics and disseminationWe use publicly accessible documents as evidence, there is no participant involvement at an individual level and an institutional ethics approval is not required. The results of the review will be sought published in a peer-reviewed journals, also in the event of insignificant results or null results, and thereby it will be disseminated to clinicians and public available.PROSPERO registration numberCRD42019139256.

show abstract

“…Such risk factors are apt to appear in AP (Gukovskaya et al, ; Habtezion, ; Hagiwara et al, ; Ranson et al, ; Rawla et al, ; Singh & Garg, ; Zhou & Chen, ). A great number of studies have assessed delirium in severe illnesses (Barbateskovic et al, ; Bhattacharya et al, ; Desforges & Lipowski, ; Desforges & Lipowski, ; Kratz, Heinrich, Schlauß, & Diefenbacher, ; Kumar, Jayant, Arya, Magoon, & Sharma, ; Li et al, ; Lundstrom, Edlund, Bucht, Karlsson, & Gustafson, ; Nie, Zhao, Zhang, Jiang, & Yang, ; Sanguineti, Wild, & Fain, ; Zhu et al, ). However, to the best of my knowledge, there are data unavailable on delirium solely in AP.…”

Section: Introductionmentioning

confidence: 99%

Serum soluble fibrinogen‐like protein 2 concentration predicts delirium after acute pancreatitis

et al. 2019

Brain and Behavior

View full text Add to dashboard Cite

Objective Inflammation can cause delirium. Soluble fibrinogen‐like protein 2 (sFGL2) is a modulator of the immune response and more recently found to be a biomarker for brain injury. This study was designed to discover the predictive capability of serum sFGL2 concentrations for delirium after acute pancreatitis (AP). Materials and Methods In this prospective, observational study, serum sFGL2 concentrations were quantified in 184 healthy controls and in 184 AP patients. Disease severity was assessed by Acute Physiology and Chronic Health Care Evaluation II score, Ranson score, multiple organ dysfunction score, and sequential organ failure assessment score. Delirium was recorded during hospital stay. Predictors of delirium were identified using multivariate analysis. Results Serum sFGL2 concentrations were substantially higher in AP patients than in controls. Serum sFGL2 concentrations were intimately correlated with the preceding severity parameters. Serum sFGL2 and the aforementioned severity parameters were independent predictors for delirium. Under receiver operating characteristic curve, the discriminatory ability of serum sFGL2 was equivalent to those of the above‐mentioned severity parameters. Moreover, serum sFGL2 dramatically improved the predictive value of the aforementioned severity parameters. Conclusions Elevation of serum sFGL2 concentrations is strongly associated with the AP severity and has the potential to distinguish delirium after AP.

show abstract

Pharmacological interventions for delirium in intensive care patients: a protocol for an overview of reviews

Cited by 21 publications

References 91 publications

Pharmacological interventions for prevention and management of delirium in intensive care patients: a systematic overview of reviews and meta-analyses

Pharmacological interventions for prevention and management of delirium in intensive care patients: a systematic overview of reviews and meta-analyses

Effects of adding adjunctive hyperbaric oxygen therapy to standard wound care for diabetic foot ulcers: a protocol for a systematic review with meta-analysis and trial sequential analysis

Serum soluble fibrinogen‐like protein 2 concentration predicts delirium after acute pancreatitis

Contact Info

Product

Resources

About