Copenhagen Trial Unit, Centre for Clinical Intervention Research, Department 7812, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
Centre for Research in Intensive Care, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
Acta Anaesthesiol Scand. 2019 Apr;63(4):540-548. doi: 10.1111/aas.13313. Epub 2019 Jan 23.
Delirium is a common complication in critically ill patients and carries an increased risk of mortality and morbidity. Dexmedetomidine can potentially prevent delirium by diminishing predisposing factors. The evidence regarding the use of dexmedetomidine in preventing delirium is conflicting. This protocol aims to identify the beneficial and harmful effects of dexmedetomidine in the prevention of delirium.
This protocol uses the recommendations of the Cochrane Collaboration, the Preferred Report Items of Systematic Reviews with Meta-Analysis Protocols, and the eight-step assessment procedure suggested by Jakobsen and colleagues. We wish to assess in critically ill patients, if dexmedetomidine versus placebo can reduce the incidence of delirium and improve clinical outcomes. We will include all randomised trials assessing the use of dexmedetomidine in the prevention of delirium. To identify trials, we will search the Cochrane Central Register of Controlled Trials, Medical Literature Analysis and Retrieval System Online, Excerpta Medica database, Latin American and Caribbean Health Sciences Literature, Science Citation Index Expanded on Web of Science, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, Chinese Science Journal Database, and BIOSIS. Two authors will screen the literature and extract data. We will use the Cochrane risk of bias tool to evaluate trials. Extracted data will be analysed using Review Manager 5 and Trial Sequential Analysis. We will create a "Summary of Findings"-table in which we will present our primary and secondary outcomes. We will assess the quality of evidence using GRADE.
This systematic review can potentially aid clinicians in decision-making and benefit the many critically ill patients at risk of delirium.
谵妄是危重症患者的常见并发症，增加了死亡率和发病率。右美托咪定通过减少易患因素，有可能预防谵妄。关于使用右美托咪定预防谵妄的证据存在争议。本方案旨在确定右美托咪定预防谵妄的有益和有害作用。
本方案使用了 Cochrane 协作组织、系统评价与荟萃分析首选报告项目以及 Jakobsen 等人建议的八步评估程序的建议。我们希望评估在危重症患者中，右美托咪定与安慰剂相比是否可以降低谵妄发生率并改善临床结局。我们将纳入所有评估右美托咪定预防谵妄的随机试验。为了确定试验，我们将检索 Cochrane 对照试验中心注册库、医学文献分析与检索系统在线、荷兰医学文摘数据库、拉丁美洲和加勒比健康科学文献、科学引文索引扩展版在 Web of Science 上、中国生物医学文献数据库、中国国家知识基础设施、中国科学期刊数据库和 BIOSIS。两名作者将筛选文献并提取数据。我们将使用 Cochrane 偏倚风险工具评估试验。提取的数据将使用 Review Manager 5 和试验序贯分析进行分析。我们将创建一个“结果总结”表，其中将呈现我们的主要和次要结局。我们将使用 GRADE 评估证据质量。
本系统评价可能有助于临床医生做出决策，并使许多有谵妄风险的危重症患者受益。
