Zilezinski Max, Denninger Natascha-Elisabeth, Tannen Antje, Kottner Jan
Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Clinical Nursing Science, Charité - Universitätsmedizin Berlin, Berlin, Germany
Department for Primary Care and Health Services Research, Nursing Science and Interprofessional Care, Heidelberg University/University Hospital Heidelberg, Heidelberg, Germany.
BMJ Open. 2025 Sep 2;15(9):e094529. doi: 10.1136/bmjopen-2024-094529.
Delirium is one of the most common forms of acute cerebral dysfunction in critically ill children, leading to increased morbidity and mortality. The aim was to identify studies describing or evaluating non-pharmacological interventions to prevent or treat paediatric delirium.
Scoping review.
Searches were performed in Medline, CINAHL, Cochrane Library, Ovid (Journals), EMBASE and Web of Science from January 2000 to April 2023. A hand search and update were conducted on 01 June 2024.
We included studies involving critically ill children (0-18 years) in intensive care settings that examined non-pharmacological interventions for the prevention or treatment of paediatric delirium. Only empirical studies and reviews with transparent methodology were considered.
Title and abstract screening and full-text review of articles were conducted by two reviewers based on prespecified inclusion criteria. Two reviewers extracted relevant information from the included studies in tabular form. Extracted variables included publication year, title, author(s), country, setting, population and age, design, sample size, intervention components, outcome(s) and findings.
Nine studies were included. In total, 16 different intervention components were identified. The most frequently reported components for preventing and treating paediatric delirium were promoting mobilisation, encouraging family presence and involvement, improving sleep, and standardised instruments or checklists for underlying aetiology. Most intervention studies were before-and-after studies; overall, seven different outcomes were used. Study results regarding the effects of delirium were inconsistent.
Various non-pharmacological interventions are currently described to mitigate paediatric delirium, but the underlying evidence is limited. High-quality intervention research using relevant and comparable outcomes is needed to evaluate the effect of non-pharmacological interventions. Despite employing a comprehensive search strategy, we must consider the possibility that relevant articles were overlooked.
谵妄是危重症儿童最常见的急性脑功能障碍形式之一，会导致发病率和死亡率上升。本研究旨在识别描述或评估预防或治疗儿童谵妄的非药物干预措施的研究。
范围综述。
于2000年1月至2023年4月在Medline、CINAHL、Cochrane图书馆、Ovid（期刊）、EMBASE和科学网进行检索。2024年6月1日进行了手工检索和更新。
我们纳入了涉及重症监护环境中危重症儿童（0至18岁）的研究，这些研究考察了预防或治疗儿童谵妄的非药物干预措施。仅考虑采用透明方法的实证研究和综述。
两名评审员根据预先设定的纳入标准对文章进行标题和摘要筛选以及全文评审。两名评审员以表格形式从纳入研究中提取相关信息。提取的变量包括发表年份、标题、作者、国家、环境、人群和年龄、设计、样本量、干预组成部分、结果和研究发现。
纳入了9项研究。总共识别出16种不同的干预组成部分。预防和治疗儿童谵妄最常报告的组成部分是促进活动、鼓励家属在场和参与、改善睡眠，以及针对潜在病因的标准化工具或清单。大多数干预研究为前后对照研究；总体而言，使用了7种不同的结果。关于谵妄影响的研究结果不一致。
目前描述了各种非药物干预措施来减轻儿童谵妄，但相关证据有限。需要开展使用相关且可比结果的高质量干预研究，以评估非药物干预措施的效果。尽管采用了全面的检索策略，但我们必须考虑可能遗漏相关文章的可能性。
