Effectiveness of combined non-pharmacological interventions in the prevention of delirium in critically ill patients: A randomized clinical trial.

Autor: Faustino TN; Programa de Pós-Graduação em Medicina e Saúde, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Bahia, Brazil; Collegiate of Nursing, Department of Life Sciences, State University of Bahia, Salvador, Bahia, Brazil. Electronic address: tassiafaustino@yahoo.com.br., Suzart NA; Assiste Vida Service, Salvador, Bahia, Brazil., Rabelo RNDS; Santa Izabel Hospital, Salvador, Bahia, Brazil., Santos JL; Collegiate of Nursing, Department of Life Sciences, State University of Bahia, Salvador, Bahia, Brazil., Batista GS; Collegiate of Nursing, Department of Life Sciences, State University of Bahia, Salvador, Bahia, Brazil., Freitas YS; Bahia School of Medicine and Public Health, Salvador, Bahia, Brazil., Saback DA; Cárdio Pulmonar Hospital, Salvador, Bahia, Brazil., Sales NMMD; Municipal Secretariat of Health, Urgency/Emergency Care Service, Salvador, Bahia, Brazil., Brandao Barreto B; Programa de Pós-Graduação em Medicina e Saúde, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Bahia, Brazil; Intensive Care Unit, Hospital da Mulher, Salvador, Bahia, Brazil., Gusmao-Flores D; Programa de Pós-Graduação em Medicina e Saúde, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Bahia, Brazil; Intensive Care Unit, Hospital da Mulher, Salvador, Bahia, Brazil.
Jazyk: angličtina
Zdroj: Journal of critical care [J Crit Care] 2022 Apr; Vol. 68, pp. 114-120. Date of Electronic Publication: 2022 Jan 06.
DOI: 10.1016/j.jcrc.2021.12.015
Abstrakt: Purpose: Delirium is a common dysfunction in the intensive care unit (ICU) and it is associated with negative short- and long-term outcomes. This study evaluated the effectiveness of combined non-pharmacological interventions in preventing delirium in critically ill patients.
Materials and Methods: This is a single-center randomized controlled trial conducted in three Brazilian ICUs from February to September 2019. Patients assigned to the control group received standard care (n = 72) and those assigned to the experimental group (n = 72) received a bundle of non-pharmacological interventions (periodic reorientation, cognitive stimulation, correction of sensory deficits [visual or hearing impairment], environmental management and sleep promotion) throughout the ICU stay. Delirium was monitored twice a day with the Confusion Assessment Method for the Intensive Care Unit Flowsheet. The primary outcome was the incidence density of delirium.
Results: The incidence density of delirium was lower in the intervention group (1.3 × 10 -2 person-days) than in the control group (2.3 × 10 -2 person-days), with a hazard ratio of 0.40 (95% confidence intervals, 0.17-0.95; p = 0.04) after adjustment for Simplified Acute Physiology Score III, surgical admission and alcoholism.
Conclusions: Combined non-pharmacological interventions reduced delirium in critically ill patients, compared to standard care.
Trial Registration: Brazilian Registry of Clinical Trials (ReBEC), Identifier RBR-6xq95s, October 03, 2018.
Competing Interests: Declaration of Competing Interest The authors declare that they have no competing interests.
(Copyright © 2022 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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