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):549-557. doi: 10.1111/aas.13329. Epub 2019 Jan 31.
Delirium is a common complication in critically ill patients and carries an increased risk of mortality and morbidity. Dexmedetomidine can potentially treat delirium by diminishing predisposing factors. The evidence regarding the use of dexmedetomidine in the management of delirium is conflicting. This protocol aims to identify the beneficial and harmful effects of dexmedetomidine in the management 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 with delirium, if dexmedetomidine vs placebo is effective in managing delirium and improving clinical outcomes. We will include all relevant randomised clinical trials assessing the use of dexmedetomidine in treating 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. The Cochrane risk of bias tool will be used to evaluate included 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 assessment.
This systematic review can potentially aid clinicians in decision making and benefit the many critically ill patients developing 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的风险。右美托咪定通过减少易患因素可能有助于治疗谵妄。关于右美托咪定在谵妄管理中的使用的证据存在矛盾。本方案旨在确定右美托咪定在谵妄管理中的有益和有害作用。
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、Jakobsen 等人提出的八步评估程序的建议。我们希望评估患有谵妄的危重症患者中，右美托咪定与安慰剂相比是否在管理谵妄和改善临床结局方面有效。我们将纳入所有评估右美托咪定治疗谵妄的相关随机临床试验。为了确定试验，我们将搜索 Cochrane 对照试验中心注册库、医学文献分析与检索系统在线、文摘医学数据库、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。两位作者将筛选文献并提取数据。使用 Cochrane 偏倚风险工具评估纳入的试验。使用 Review Manager 5 和试验序贯分析分析提取的数据。我们将创建一个“研究结果总结”-表，其中我们将呈现我们的主要和次要结局。我们将使用 GRADE 评估来评估证据质量。
本系统评价可以帮助临床医生做出决策，并使许多患有谵妄的危重症患者受益。
