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通过非药物干预预防重症监护病房中的谵妄:一项伞状综述

Prevention of Delirium in the Intensive Care Unit through Nonpharmacological Interventions: An Umbrella Review.

作者信息

Sonia Moirangthem, Kaur Sukhpal, Kothari Nikhil

机构信息

Department of Nursing, All India Institute of Medical Sciences (AIIMS), Jodhpur, Rajasthan, India.

Department of Nursing Education, National Institute of Nursing Education, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

出版信息

Indian J Crit Care Med. 2025 Jan;29(1):75-83. doi: 10.5005/jp-journals-10071-24884. Epub 2024 Dec 30.

Abstract

INTRODUCTION

Delirium is a syndrome commonly seen in intensive care unit (ICU) patients. It is characterized by acute changes in mental status, inattention, disorganized thinking, and altered level of consciousness. Due to its higher prevalence in mechanically ventilated ICU patients, it is crucial to recognize it early and implement standardized evidence-based protocols for preventing it in regular practice.

OBJECTIVES

To identify the benefits and effectiveness of nonpharmacological interventions for preventing delirium among critically ill patients admitted to the ICU.

METHODS

The preferred reporting items for systematic reviews and meta-analyses statement guidelines were followed. Two independent authors searched electronic and grey literature for systematic review and meta-analysis in the following databases: PubMed, Scopus, Web of Science, Cochrane Database of Systematic Reviews, and Google Scholar.

RESULTS

This umbrella review included 12 studies on delirium prevention interventions, excluding reviews, abstracts, case studies, and pharmacological interventions. Our finding shows that multicomponent strategies are the most promising intervention for preventing delirium. Inclusion of family participation is the most vital part, with flexible visitation to be included in delirium care protocols. Multidisciplinary approaches raise workloads among healthcare professionals through increased coordination, assessments, and documentation.

CONCLUSIONS

Multicomponent interventions are regarded as the most effective among all nonpharmacological interventions for reducing and preventing delirium.

HIGHLIGHTS

Delirium syndrome is preventable among mechanically ventilated patients. The study aims to identify the benefits and effectiveness of nonpharmacological interventions for preventing delirium among critically ill patients admitted to the ICU.

HOW TO CITE THIS ARTICLE

Sonia M, Kaur S, Kothari N. Prevention of Delirium in the Intensive Care Unit through Nonpharmacological Interventions: An Umbrella Review. Indian J Crit Care Med 2025;29(1):75-83.

摘要

引言

谵妄是重症监护病房(ICU)患者中常见的一种综合征。其特征为精神状态急性改变、注意力不集中、思维紊乱以及意识水平改变。由于在机械通气的ICU患者中其患病率较高,因此在日常实践中尽早识别并实施标准化的循证方案以预防谵妄至关重要。

目的

确定非药物干预措施对预防入住ICU的重症患者谵妄的益处和有效性。

方法

遵循系统评价和荟萃分析的首选报告项目声明指南。两位独立作者在以下数据库中检索电子文献和灰色文献以进行系统评价和荟萃分析:PubMed、Scopus、科学网、Cochrane系统评价数据库和谷歌学术。

结果

本综述性述评纳入了12项关于谵妄预防干预措施的研究,排除了综述、摘要、病例研究和药物干预措施。我们的研究结果表明,多组分策略是预防谵妄最有前景的干预措施。纳入家属参与是最为关键的部分,应将灵活探视纳入谵妄护理方案。多学科方法通过加强协调、评估和记录增加了医护人员的工作量。

结论

在所有预防谵妄的非药物干预措施中,多组分干预被认为是最有效的。

要点

机械通气患者的谵妄综合征是可预防的。本研究旨在确定非药物干预措施对预防入住ICU重症患者谵妄的益处和有效性。

如何引用本文

索尼娅·M、考尔·S、科塔里·N。通过非药物干预措施预防重症监护病房谵妄:一项综述性述评。《印度重症监护医学杂志》2025;29(1):75 - 83。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1068/11719550/d3051679f0a3/ijccm-29-75-g001.jpg

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