What is the Delirium Bibliography? The searchable Delirium Bibliography page is one of our most popular features, allowing you to quickly gain access to the literature on delirium and acute care of older persons. It is primarily intended for clinicians and researchers interested in exploring these topics. The NIDUS team keeps it updated for you on a monthly basis!
How to Search for Articles: Search by author, title, year, and/or keywords. Each article is indexed by keywords taken from MEDLINE and other relevant databases. Click on the title of the article to read the abstract, journal, etc.
Reference Information
- Title
- Effectiveness and harms of pharmacological interventions for the treatment of delirium in adults in intensive care units after cardiac surgery: a systematic review
- Authors
- Leigh, V. Stern, C. Elliott, R. Tufanaru, C.
- Year
- 2019
- Journal
- JBI Database System Rev Implement Rep
- Abstract
OBJECTIVE: The objective of this review was to synthesize the best available evidence on the effectiveness and harms of pharmacological interventions for the treatment of delirium in adult patients in the intensive care unit (ICU) after cardiac surgery. INTRODUCTION: Patients who undergo cardiac surgery are at high risk of delirium (incidence: 50-90%). Delirium has deleterious effects, increasing the risk of death and adversely affecting recovery. Clinical interventional trials have been conducted to prevent and treat postoperative delirium pharmacologically including antipsychotics and sedatives. These trials have provided some evidence about efficacy and influenced clinical decision making. However, much reporting is incomplete and provides biased assessments of efficacy; benefits are emphasized while harms are inadequately reported. INCLUSION CRITERIA: Participants were >/= 16 years, any sex or ethnicity, who were treated postoperatively in a cardiothoracic ICU following cardiac surgery and were identified as having delirium. Any pharmacological intervention for the treatment of delirium was included, regardless of drug classification, dosage, intensity or frequency of administration. Outcomes of interest of this review were: mortality, duration and severity of delirium, use of physical restraints, quality of life, family members’ satisfaction with delirium management, duration/severity of the aggressive episode, associated falls, severity of accidental self-harm, pharmacological harms, harms related to over-sedation, ICU length of stay, hospital length of stay (post ICU), total hospital length of stay, need for additional intervention medication and need for rescue medication. Randomized controlled trials were considered first and in their absence, non-randomized controlled trials and quasi-experimental would have been considered, followed by analytical observational studies. METHODS: A search was conducted in PubMed, Embase, CINAHL, Web of Science, Cochrane Central Register of Controlled Trials, Scopus, Epistemonikos, Australian New Zealand Clinical Trials Registry, ClinicalTrials.gov, Clinical Trials in New Zealand, and ProQuest Dissertations and Theses to locate both published and unpublished studies. There was no date limit for the search. A hand search for primary studies published between January 1, 2012 and November 17, 2018 in relevant journals was also conducted. Only studies published in English were considered for inclusion. Two reviewers independently assessed the methodological quality using standardized critical appraisal instruments from JBI and McMaster University. Quantitative data were extracted using the standardized JBI data extraction tool. A meta-analysis was not performed, as there was too much clinical and methodological heterogeneity in the included studies. Results have been presented in a narrative form. Standard GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) evidence assessment of outcomes has been reported. RESULTS: Three RCTs investigating morphine versus haloperidol (n = 53), ondansetron versus haloperidol (n = 72), and dexmedetomidine versus midazolam (n = 80) were included. Due to heterogeneity and incomplete reporting, a meta-analysis was not feasible. Overall, the methodological quality of these studies was found to be low. Additionally, this review found reporting of harms to be inadequate and superficial for all three studies and did not meet the required standards for harms reporting, as defined by the CONSORT statement extension for harms. CONCLUSIONS: It was not possible to draw any valid conclusions regarding the effectiveness of morphine vs haloperidol, ondansetron vs haloperidol or dexmedetomidine vs midazolam in treating delirium after cardiac surgery. This is due to the low number of studies, the poor methodological quality in conducting and reporting and the heterogeneity between the studies.
- PMID
- Keywords
- Page(s)
- Volume
- Issue
| Title | Authors | Journal | Year | Keywords |
|---|---|---|---|---|
| Factors Associated with Length of Stay in Hospital Patients with and Without Dementia. | Möllers, T. Perna, L. Ihle, P. Schubert, I. Bauer, J. Brenner, H. | Journal of Alzheimer's Disease | 2019 |
adult |
| Does a Year Have 6 Months or 12? Implications for Delirium Detection Among Hospitalized Older General Medicine Patients. | Zhou, W. Ngo, L. H. Inouye, S. K. Gallagher, J. Husser, E. K. Fick, D. M. Marcantonio, E. R. | Journal of General Internal Medicine | 2018 |
adult |
| Serum soluble fibrinogen-like protein 2 concentration predicts delirium after acute pancreatitis. | Xu, W. B. Hu, Q. H. Wu, C. N. Fan, Z. K. Song, Z. F. | Brain Behav | 2019 |
acute pancreatitis |
| Use of the brief Confusion Assessment Method in a veteran palliative care population: A pilot validation study. | Wilson, J. E. Boehm, L. Samuels, L. R. Unger, D. Leonard, M. Roumie, C. Ely, E. W. Dittus, R. S. Misra, S. Han, J. H. | Palliat Support Care | 2019 |
cognition |
| Relative cerebral hyperperfusion during cardiopulmonary bypass is associated with risk for postoperative delirium: a cross-sectional cohort study. | Thudium, M. Ellerkmann, R. K. Heinze, I. Hilbert, T. | BMC Anesthesiology | 2019 |
Cardiac surgery |
| Prediction of postoperative delirium by comprehensive geriatric assessment among elderly patients with hip fracture. | Tao, L. Xiaodong, X. Qiang, M. Jiao, L. Xu, Z. | Ir J Med Sci | 2019 |
Comprehensive geriatric assessment |
| The Overlap Between Falls and Delirium in Hospitalized Older Adults: A Systematic Review. | Sillner, A. Y. Holle, C. L. Rudolph, J. L. | Clin Geriatr Med | 2019 |
Delirium |
| Depth of sedation as an interventional target to reduce postoperative delirium: mortality and functional outcomes of the Strategy to Reduce the Incidence of Postoperative Delirium in Elderly Patients randomised clinical trial. | Sieber, F. Neufeld, K. J. Gottschalk, A. Bigelow, G. E. Oh, E. S. Rosenberg, P. B. Mears, S. C. Stewart, K. J. Ouanes, J. P. P. Jaberi, M. Hasenboehler, E. A. Wang, N. Y. | British Journal of Anaesthesia | 2019 |
NCT00590707 |
| Delirium Incidence and Functional Outcomes After Transcatheter and Surgical Aortic Valve Replacement. | Shi, S. M. Sung, M. Afilalo, J. Lipsitz, L. A. Kim, C. A. Popma, J. J. Khabbaz, K. R. Laham, R. J. Guibone, K. Lee, J. Marcantonio, E. R. Kim, D. H. | J Am Geriatr Soc | 2019 |
aortic valve replacement |
| Effect of perioperative administration of dexmedetomidine on delirium after cardiac surgery in elderly patients: a double-blinded, multi-center, randomized study. | Shi, C. Jin, J. Qiao, L. Li, T. Ma, J. Ma, Z. | Clin Interv Aging | 2019 |
anesthesia |
| Perspectives on the Delirium Experience and Its Burden: Common Themes Among Older Patients, Their Family Caregivers, and Nurses. | Schmitt, E. M. Gallagher, J. Albuquerque, A. Tabloski, P. Lee, H. J. Gleason, L. Weiner, L. S. Marcantonio, E. R. Jones, R. N. Inouye, S. K. Schulman-Green, D. | Gerontologist | 2019 |
*Burden |
| Association of Persistent Intense Thirst With Delirium Among Critically Ill Patients: A Cross-sectional Study. | Sato, K. Okajima, M. Taniguchi, T. | J Pain Symptom Manage | 2019 |
Thirst |
| Role of Epileptic Activity in Older Adults With Delirium, a Prospective Continuous EEG Study. | Sambin, S. Gaspard, N. Legros, B. Depondt, C. De Breucker, S. Naeije, G. | Front Neurol | 2019 |
Ncse |
| Surgical delay is a risk factor of delirium in hip fracture patients with mild–moderate cognitive impairment. | Pioli, G. Bendini, C. Giusti, A. Pignedoli, P. Cappa, M. Iotti, E. Ferri, M. A. Bergonzini, E. Sabetta, E. | Aging Clinical and Experimental Research | 2019 |
age |
| Cerebrospinal Fluid Spermidine, Glutamine and Putrescine Predict Postoperative Delirium Following Elective Orthopaedic Surgery. | Pan, X. Cunningham, E. L. Passmore, A. P. McGuinness, B. McAuley, D. F. Beverland, D. O'Brien, S. Mawhinney, T. Schott, J. M. Zetterberg, H. Green, B. D. | Sci Rep | 2019 | |
| The impact of the Hospital Elder Life Program on the treatment of asymptomatic bacteriuria: An unexpected benefit. | O'Donnell, A. J. Walsh, T. L. Tang, A. Weinberg, L. | Geriatr Nurs | 2019 |
Asymptomatic bacteriuria |
| Continuous EEG Monitoring in a Consecutive Patient Cohort with Sepsis and Delirium. | Nielsen, R. M. Urdanibia-Centelles, O. Vedel-Larsen, E. Thomsen, K. J. Moller, K. Olsen, K. S. Lauritsen, A. O. Eddelien, H. S. Lauritzen, M. Benedek, K. | Neurocrit Care | 2019 |
Brain diseases |
| Delirium risk factors and associated outcomes in a neurosurgical cohort: a case-control study. | Morshed, R. A. Young, J. S. Safaee, M. Sankaran, S. Berger, M. S. McDermott, M. W. Hervey-Jumper, S. L. | World Neurosurg | 2019 |
Delirium |
| Biomarker Predictors of Delirium in Acutely Ill Patients: A Systematic Review. | Michels, M. Michelon, C. Damasio, D. Vitali, A. M. Ritter, C. Dal-Pizzol, F. | J Geriatr Psychiatry Neurol | 2019 |
Cam |
| Predicting postoperative delirium severity in older adults: The role of surgical risk and executive function. | Lindroth, H. Bratzke, L. Twadell, S. Rowley, P. Kildow, J. Danner, M. Turner, L. Hernandez, B. Brown, R. Sanders, R. D. | Int J Geriatr Psychiatry | 2019 |
aging |
| Subsyndromal delirium is associated with poor functional outcome after ischaemic stroke. | Klimiec-Moskal, E. Lis, A. Pera, J. Slowik, A. Dziedzic, T. | European Journal of Neurology | 2019 |
aged |
| SF-36 scores predict postoperative delirium after surgery for cervical spondylotic myelopathy. | Kin, K. Yasuhara, T. Tomita, Y. Umakoshi, M. Morimoto, J. Date, I. | J Neurosurg Spine | 2019 |
CCI = Charlson Comorbidity Index |
| Effects of massage on outcomes of adult intensive care unit patients: a systematic review. | Jagan, S. Park, T. Papathanassoglou, E. | Nurs Crit Care | 2019 |
Complementary and alternative therapies |
| Perioperative Dexmedetomidine Reduces Delirium in Elderly Patients after Lung Cancer Surgery. | Huyan, T. Hu, X. Peng, H. Zhu, Z. Li, Q. Zhang, W. | Psychiatr Danub | 2019 | |
| The Oslo Study of Clonidine in Elderly Patients with Delirium; LUCID: a randomised placebo-controlled trial. | Hov, K. R. Neerland, B. E. Undseth, O. Bruun Bratholm Wyller, V. MacLullich, A. M. J. Qvigstad, E. Skovlund, E. Wyller, T. B. | Int J Geriatr Psychiatry | 2019 |
Delirium treatment |
| Delirium and Alzheimer disease: A proposed model for shared pathophysiology. | Fong, T. G. Vasunilashorn, S. M. Libermann, T. Marcantonio, E. R. Inouye, S. K. | Int J Geriatr Psychiatry | 2019 |
Alzheimer disease |
| Development and validation of a dynamic delirium prediction rule in patients admitted to the Intensive Care Units (DYNAMIC-ICU): A prospective cohort study. | Fan, H. Ji, M. Huang, J. Yue, P. Yang, X. Wang, C. Ying, W. | International journal of nursing studies | 2019 |
aged |
| Delirium and cognitive impairment among older patients in Norwegian emergency departments. | Evensen, S. Saltvedt, I. Ranhoff, A. H. Myrstad, M. Myrstad, C. Mellingsaeter, M. Wang-Hansen, M. S. Neerland, B. E. | Tidsskr Nor Laegeforen | 2019 | |
| Motor activity across delirium motor subtypes in geriatric patients assessed using body-worn sensors: a Norwegian cross-sectional study. | Evensen, S. Bourke, A. K. Lydersen, S. Sletvold, O. Saltvedt, I. Wyller, T. B. Taraldsen, K. | BMJ Open | 2019 |
accelerometer |
| Factors Associated With Delirium in Surgical Intensive Care Unit Patients Treated With Supplemental Melatonin: A Case-Cohort Study. | Cusimano, J. M. Welch, S. Perez-Protto, S. Lam, S. | Clin Neuropharmacol | 2019 | |
| Intraoperative blood transfusion predicts postoperative delirium among older patients undergoing elective orthopedic surgery: A prospective cohort study. | Chou, M. Y. Wang, Y. C. Peng, L. N. Liang, C. K. Chu, C. S. Liao, M. C. Lin, Y. T. Hsu, C. J. Chen, L. K. | Int J Geriatr Psychiatry | 2019 |
aged |
| Postoperative delirium in critically ill surgical patients: incidence, risk factors, and predictive scores. | Chaiwat, O. Chanidnuan, M. Pancharoen, W. Vijitmala, K. Danpornprasert, P. Toadithep, P. Thanakiattiwibun, C. | BMC Anesthesiology | 2019 |
Intensive care unit (ICU) |
| Differential Clinical Characteristics, Management, and Outcome of Delirium among Ward Compared with ICU Patients. | Canet, E. Amjad, S. Robbins, R. Lewis, J. Matalanis, M. Jones, D. Bellomo, R. | Intern Med J | 2019 |
Agitation |
| Vitamin D levels and risk of delirium: A mendelian randomization study in the UK Biobank. | Bowman, K. Jones, L. Pilling, L. C. Delgado, J. Kuchel, G. A. Ferrucci, L. Fortinsky, R. H. Melzer, D. | Neurology | 2019 | |
| Single-bed rooms in a geriatric ward prevent delirium in older patients. | Blandfort, S. Gregersen, M. Rahbek, K. Juul, S. Damsgaard, E. M. | Aging Clin Exp Res | 2019 |
Delirium |
| Drug Prescription and Delirium in Older Inpatients: Results From the Nationwide Multicenter Italian Delirium Day 2015-2016. | Aloisi, G. Marengoni, A. Morandi, A. Zucchelli, A. Cherubini, A. Mossello, E. Bo, M. Di Santo, S. G. Mazzone, A. Trabucchi, M. Cappa, S. Fimognari, F. L. Incalzi, R. A. Gareri, P. Perticone, F. Campanini, M. Montorsi, M. Latronico, N. Zambon, A. Bellelli, | J Clin Psychiatry | 2019 | |
| Patient Safety Incidents Describing Patient Falls in Critical Care in North West England Between 2009 and 2017. | Thomas, A. N. Balmforth, J. E. | J Patient Saf | 2019 | |
| Have you SCAND MMe Please? A framework to prevent harm during acute hospitalisation of older persons: A retrospective audit. | Redley, B. Baker, T. | Journal of Clinical Nursing | 2019 |
acute disease |
| Low-Dose Ketamine Infusion to Decrease Postoperative Delirium for Spinal Fusion Patients. | Plyler, S. S. Muckler, V. C. Titch, J. F. Gupta, D. K. Rice, A. N. | J Perianesth Nurs | 2019 |
3d-cam |
| Nurses' experiences of caring for older patients afflicted by delirium in a neurological department. | Kristiansen, S. Konradsen, H. Beck, M. | Journal of Clinical Nursing | 2019 |
adult |
| Association of Delirium Response and Safety of Pharmacological Interventions for the Management and Prevention of Delirium: A Network Meta-analysis. | Wu, Y. C. Tseng, P. T. Tu, Y. K. Hsu, C. Y. Liang, C. S. Yeh, T. C. Chen, T. Y. Chu, C. S. Matsuoka, Y. J. Stubbs, B. Carvalho, A. F. Wada, S. Lin, P. Y. Chen, Y. W. Su, K. P. | JAMA Psychiatry | 2019 | |
| Effect of electroencephalography-guided anesthetic administration on postoperative delirium among older adults undergoing major surgery the engages randomized clinical trial. | Wildes, T. S. Mickle, A. M. Abdallah, A. B. Maybrier, H. R. Oberhaus, J. Budelier, T. P. Kronzer, A. McKinnon, S. L. Park, D. Torres, B. A. Graetz, T. J. Emmert, D. A. Palanca, B. J. Goswami, S. Jordan, K. Lin, N. Fritz, B. A. Stevens, T. W. Jacobsohn, E. | JAMA | 2019 |
NCT02241655 |
| Perioperative Epidural Use and Risk of Delirium in Surgical Patients: A Secondary Analysis of the PODCAST Trial. | Vlisides, P. E. Thompson, A. Kunkler, B. S. Maybrier, H. R. Avidan, M. S. Mashour, G. A. | Anesth Analg | 2019 | |
| Effect of Intravenous Acetaminophen vs Placebo Combined with Propofol or Dexmedetomidine on Postoperative Delirium among Older Patients Following Cardiac Surgery: The DEXACET Randomized Clinical Trial. | Subramaniam, B. Shankar, P. Shaefi, S. Mueller, A. O'Gara, B. Banner-Goodspeed, V. Gallagher, J. Gasangwa, D. Patxot, M. Packiasabapathy, S. Mathur, P. Eikermann, M. Talmor, D. Marcantonio, E. R. | JAMA | 2019 |
NCT02546765 |
| The use of a screening scale improves the recognition of delirium in older patients after cardiac surgery - a retrospective observational study. | Smulter, N. Claesson Lingehall, H. Gustafson, Y. Olofsson, B. Engstrom, K. G. | J Clin Nurs | 2019 |
Assessments scales |
| Incidence and predictors of postoperative delirium in the older acute care surgery population: a prospective study. | Saravana-Bawan, B. Warkentin, L. M. Rucker, D. Carr, F. Churchill, T. A. Khadaroo, R. G. | Canadian Journal of Surgery | 2019 |
aged |
| Association of Duration of Surgery With Postoperative Delirium Among Patients Receiving Hip Fracture Repair. | Ravi, B. Pincus, D. Choi, S. Jenkinson, R. Wasserstein, D. N. Redelmeier, D. A. | JAMA Netw Open | 2019 | |
| Depression Predicts Delirium After Coronary Artery Bypass Graft Surgery Independent of Cognitive Impairment and Cerebrovascular Disease: An Analysis of the Neuropsychiatric Outcomes After Heart Surgery Study. | Oldham, M. A. Hawkins, K. A. Lin, I. H. Deng, Y. Hao, Q. Scoutt, L. M. Yuh, D. D. Lee, H. B. | American Journal of Geriatric Psychiatry | 2019 |
aged |
| Accuracy of the Delirium Observational Screening Scale (DOS) as a screening tool for delirium in patients with advanced cancer. | Neefjes, E. C. W. van der Vorst, Mjdl Boddaert, M. S. A. Verdegaal, Batt Beeker, A. Teunissen, S. C. C. Beekman, A. T. F. Zuurmond, W. W. A. Berkhof, J. Verheul, H. M. W. | BMC Cancer | 2019 |
Delirium |
| The impact of intravenous isotonic and hypotonic maintenance fluid on the risk of delirium in adult postoperative patients: retrospective before-after observational study. | Nagae, M. Egi, M. Furushima, N. Okada, M. Makino, S. Mizobuchi, S. | J Anesth | 2019 |
Delirium |
| Association between delirium, adverse clinical events and functional outcomes in older patients admitted to rehabilitation settings after a hip fracture: A multicenter retrospective cohort study. | Morandi, A. Mazzone, A. Bernardini, B. Suardi, T. Prina, R. Pozzi, C. Gentile, S. Trabucchi, M. Bellelli, G. | Geriatrics & Gerontology International | 2019 |
aged |
| Handover of anesthesia care is associated with an increased risk of delirium in elderly after major noncardiac surgery: results of a secondary analysis. | Liu, G. Y. Su, X. Meng, Z. T. Cui, F. Li, H. L. Zhu, S. N. Wang, D. X. | J Anesth | 2019 |
Delirium |
| Undiagnosed delirium is frequent and difficult to predict: Results from a prevalence survey of a tertiary hospital. | Lange, P. W. Lamanna, M. Watson, R. Maier, A. B. | J Clin Nurs | 2019 |
Undiagnosed delirium |