Department of Pharmacy, Pharmacy and Therapeutics, Pittsburgh Poison Center of UPMC, UPMC Presbyterian Hospital, University of Pittsburgh School of Pharmacy, Pittsburgh, PA, USA.
University of Pittsburgh School of Pharmacy, Pittsburgh, PA, USA.
J Intensive Care Med. 2020 Feb;35(2):107-117. doi: 10.1177/0885066618805965. Epub 2018 Oct 11.
Conflicting data exists on the pharmacologic management of intensive care unit (ICU) delirium. This review appraises the current evidence of pharmacologic management of ICU delirium.
A systematic literature search of MEDLINE and Embase was conducted to answer the population, intervention, comparison, and outcome (PICO) question of: "Does the use of a pharmacologic agent compared to standard of care or placebo improve ICU delirium in a critically ill patient population?"
After application of the PICO question and the inclusion and exclusion criteria, 13 articles were included. Of these articles, 7 were prospective randomized controlled trials, 1 was a prospective nonrandomized controlled trial, and 5 were retrospective investigations. The included articles differed in the agents evaluated, primary outcome, and method of identifying delirium.
The variability of outcomes illustrates the need for a large-scale investigation to further evaluate the role of pharmacologic management of ICU delirium.
关于重症监护病房（ICU）谵妄的药物治疗存在相互矛盾的数据。本综述评估了 ICU 谵妄药物治疗的现有证据。
对 MEDLINE 和 Embase 进行系统文献检索，以回答以下人群、干预、比较和结局（PICO）问题：“与常规护理或安慰剂相比，使用药物治疗是否能改善重症患者的 ICU 谵妄？”
应用 PICO 问题和纳入排除标准后，共纳入 13 篇文章。其中，7 篇为前瞻性随机对照试验，1 篇为前瞻性非随机对照试验，5 篇为回顾性研究。纳入的文章在评估的药物、主要结局和识别谵妄的方法上存在差异。
结果的可变性表明需要进行大规模调查，以进一步评估 ICU 谵妄药物治疗的作用。
