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以睡眠为导向的非药物干预措施对预防谵妄的效果:随机对照试验的系统评价

The effect of sleep-oriented non-pharmacological interventions in preventing delirium: a systematic review of randomized controlled trials.

作者信息

Yayla Ezgi Mutluay, Serin Emine Kaplan

机构信息

Ezgi Mutluay Yayla, Health Sciences Faculty, Tarsus University, 33400 Mersin, Turkey,

出版信息

Croat Med J. 2025 Aug 31;66(4):289-298.

Abstract

AIM

To systematically review randomized controlled trials evaluating the efficacy of sleep-oriented non-pharmacological interventions for delirium prevention in intensive care units.

METHODS

We searched PubMed, Web of Science, Scopus, and the Cochrane Library for randomized controlled trials evaluating the efficacy of sleep-oriented, non-pharmacological interventions for delirium prevention in intensive care units published in English between 2019 and 2024. The methodological quality of the included studies was independently evaluated by two researchers using the Joanna Briggs Institute tool.

RESULTS

This review included eight randomized controlled trials (n = 649). Six studies assessed the effect of earplugs and masks on delirium prevention in intensive care patients. Three studies indicated that earplugs and eye masks effectively prevented delirium, while three studies found no effect. One study assessed the use of earplugs and masks as part of a bundle of interventions and reported a positive effect. Four studies showed an effect on sleep. None of the sleep-oriented non-pharmacological interventions assessed in these studies reported any harmful effects.

CONCLUSION

Although several high-quality studies showed that these interventions significantly lowered delirium incidence, some trials found no effect, highlighting variability in outcomes.

摘要

目的

系统评价评估以睡眠为导向的非药物干预措施预防重症监护病房谵妄疗效的随机对照试验。

方法

我们在PubMed、科学网、Scopus和Cochrane图书馆中检索了2019年至2024年期间以英文发表的评估以睡眠为导向的非药物干预措施预防重症监护病房谵妄疗效的随机对照试验。两名研究人员使用乔安娜·布里格斯研究所工具独立评估纳入研究的方法学质量。

结果

本综述纳入了八项随机对照试验(n = 649)。六项研究评估了耳塞和眼罩对重症监护患者谵妄预防的效果。三项研究表明耳塞和眼罩可有效预防谵妄,而三项研究未发现效果。一项研究评估了将耳塞和眼罩作为一系列干预措施的一部分的使用情况,并报告了积极效果。四项研究显示对睡眠有影响。这些研究中评估的以睡眠为导向的非药物干预措施均未报告任何有害影响。

结论

尽管多项高质量研究表明这些干预措施显著降低了谵妄发生率,但一些试验未发现效果,突出了结果的变异性。

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