Dexmedetomidine in prevention and treatment of postoperative and intensive care unit delirium: a systematic review and meta-analysis

Annals of Intensive Care
Julian FlükigerMartin Siegemund

Abstract

To determine the preventive and therapeutic effect of dexmedetomidine on intensive care unit (ICU) delirium. The literature search using PubMed and the Cochrane Central Register of Controlled Trials was performed (August 1, 2018) to detect all randomized controlled trials (RCTs) of adult ICU patients receiving dexmedetomidine. Articles were included if they assessed the influence of dexmedetomidine compared to a sedative agent on incidence of ICU delirium or treatment of this syndrome. Accordingly, relevant articles were allocated to the following two groups: (1) articles that assessed the delirium incidence (incidence comparison) or articles that assessed the treatment of delirium (treatment comparison). Incidence of delirium and delirium resolution were the primary outcomes. We combined treatment effects comparing dexmedetomidine versus (1) placebo, (2) standard sedatives, and (3) opioids in random-effects meta-analyses. Risk of bias for each included RCT was assessed following Cochrane standards. The literature search resulted in 28 articles (25 articles/4975 patients for the incidence comparison and three articles/166 patients for the treatment comparison). In the incidence comparison, heterogeneity was present in different...Continue Reading

References

Jul 12, 2002·Statistics in Medicine·Julian P T Higgins, Simon G Thompson
Oct 28, 2003·Journal of Cardiothoracic and Vascular Anesthesia·Daniel L HerrMichael England
Apr 15, 2004·JAMA : the Journal of the American Medical Association·E Wesley ElyRobert S Dittus
May 14, 2005·Critical Care Medicine·Stephanie Mallow CorbettBruce J Leavitt
Mar 15, 2006·Current Opinion in Anaesthesiology·Andrea Paris, Peter H Tonner
Dec 26, 2006·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·Paul M SzumitaMichael E Wechsler
Nov 17, 2007·Acta Anaesthesiologica Scandinavica·E HuupponenS Jääskeläinen
Dec 13, 2007·JAMA : the Journal of the American Medical Association·Pratik P PandharipandeE Wesley Ely
Jun 17, 2008·Critical Care : the Official Journal of the Critical Care Forum·Timothy D GirardE Wesley Ely
Sep 17, 2008·Intensive Care Medicine·Esko RuokonenUNKNOWN "Dexmedetomidine for Continuous Sedation" Investigators
May 21, 2009·Critical Care : the Official Journal of the Critical Care Forum·Michael C ReadeRinaldo Bellomo
Jul 2, 2009·Psychosomatics·José R MaldonadoBruce A Reitz
Oct 1, 2010·European Journal of Anaesthesiology·Jean MantzSophie Hamada
Dec 21, 2010·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Robert D Sanders, Mervyn Maze
Oct 20, 2011·BMJ : British Medical Journal·Julian P T HigginsUNKNOWN Cochrane Statistical Methods Group
Nov 15, 2011·Anesthesiology Clinics·Richard R Riker, Gilles L Fraser
Mar 23, 2012·JAMA : the Journal of the American Medical Association·Stephan M JakobUNKNOWN Dexmedetomidine for Long-Term Sedation Investigators
Dec 25, 2012·Critical Care Medicine·John A McPhersonPratik P Pandhvaripande
Dec 28, 2012·Critical Care Medicine·Juliana BarrUNKNOWN American College of Critical Care Medicine
May 31, 2013·The Annals of Pharmacotherapy·Yoonsun Mo, Anthony E Zimmermann
Sep 11, 2014·The Korean Journal of Thoracic and Cardiovascular Surgery·Jae Bum ParkJe Kyoun Shin
May 20, 2015·Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons·Xudong YangRuichang Liu
Oct 13, 2015·Journal of Cardiothoracic and Vascular Anesthesia·Alexa HollingerLuzius A Steiner
Mar 16, 2016·JAMA : the Journal of the American Medical Association·Michael C ReadeUNKNOWN Australian and New Zealand Intensive Care Society Clinical Trials Group
Sep 30, 2016·Statistical Methods in Medical Research·Dehui LuoTiejun Tong
Mar 23, 2017·JAMA : the Journal of the American Medical Association·Yu KawazoeUNKNOWN Dexmedetomidine for Sepsis in Intensive Care Unit Randomized Evaluation (DESIRE) Trial Investigators

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Citations

Jan 23, 2019·Minerva anestesiologica·Cydni Williams, Susan L Bratton
Oct 1, 2019·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Leslie A DervanR Scott Watson
Jul 3, 2019·Annals of Intensive Care·Katharina ToftAlexa Hollinger
Jun 27, 2019·World Journal of Critical Care Medicine·Marco CascellaRaffaela Di Napoli
Apr 29, 2020·MMW Fortschritte der Medizin·Götz GerresheimAlexander Schuh
Jun 13, 2020·BMJ Supportive & Palliative Care·Akiko ManoEiichi Saito
Oct 6, 2020·Annals of Internal Medicine·Melissa L P Mattison
Feb 9, 2021·Journal of Clinical Pharmacology·James W SchurrPaul M Szumita
Jun 5, 2021·Frontiers in Pharmacology·Risako KatoKen Solt
Jul 25, 2021·Journal of Clinical Medicine·Marina KotsaniAthanase Benetos
Aug 11, 2021·Australian Critical Care : Official Journal of the Confederation of Australian Critical Care Nurses·Debbie LongBelinda Dow

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Methods Mentioned

BETA
sedation

Software Mentioned

R
Cochrane Review Manager

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