000145732 001__ 145732
000145732 005__ 20241122130824.0
000145732 0247_ $$2doi$$a10.3390/nursrep14040219
000145732 0248_ $$2sideral$$a140688
000145732 037__ $$aART-2024-140688
000145732 041__ $$aeng
000145732 100__ $$aZaher-Sánchez, Sarai
000145732 245__ $$aThe Management and Prevention of Delirium in Elderly Patients Hospitalised in Intensive Care Units: A Systematic Review
000145732 260__ $$c2024
000145732 5060_ $$aAccess copy available to the general public$$fUnrestricted
000145732 5203_ $$aBackground: Delirium or an acute confusional state (ACS) is characterised as being a frequent and complex hospital complication in older adult patients, which can affect their level of independence and increase patient morbidity and mortality. Critically ill patients in the intensive care unit (ICU) frequently develop ICU delirium, leading to longer hospital and ICU stays, increased mortality and long-term impairment. Objectives: This review aims to assess existing evidence of interventions that can be considered effective for the management and prevention of delirium in ICUs, reducing short-term morbidity and mortality, ICU and hospital admission times and the occurrence of other long-term complications. Methodology: For this systematic review, we searched Medline, PubMed, Cochrane Library, CINHAL, LILACS, SciELO and Dialnet from January 2018 to August 2024, in English, Spanish and French. MeSH descriptors were adjusted to search the different databases. We also checked Prospero for ongoing systematic reviews. Main results: The electronic search yielded a total of 2656 studies, of which 14 trials met the eligibility criteria, with a total of 14,711 participants. We included eight randomised clinical trial (RCTs), four cohort analyses, one systematic review and one observational trial, including participants over 65 years admitted to the ICU. Ten of these studies were based on pharmacological interventions, three of them examined non-pharmacological interventions and the remaining study examined mixed (pharmacological and non-pharmacological) interventions. Six placebo RCTs were included, plus four reported comparisons between different drugs. Regarding non-pharmacological interventions, nursing programmes focused on optimising modifiable risk factors or the use of therapies such as bright light are emerging. Regarding mixed interventions, we found the combination of invasive techniques and with sedoanalgesia. Conclusions: Due to its satisfactory level of sedation, dexmedetomidine is presented as a viable option because, although olanzapine offers safer results, postoperative administration angiotensin inhibitor systems significantly reduced the incidence of delirium. As for propofol, no significant differences were found. Among the non-pharmacological and mixed therapies, bright light therapy was able to reduce the incidence of delirium, and the combination of epidural/general anaesthesia was effective in all subtypes of delirium. Concerning the remaining interventions, the scientific evidence is still insufficient to provide a definitive recommendation.
000145732 540__ $$9info:eu-repo/semantics/openAccess$$aby$$uhttp://creativecommons.org/licenses/by/3.0/es/
000145732 655_4 $$ainfo:eu-repo/semantics/review$$vinfo:eu-repo/semantics/publishedVersion
000145732 700__ $$0(orcid)0000-0003-0083-5940$$aSatústegui-Dordá, Pedro José$$uUniversidad de Zaragoza
000145732 700__ $$0(orcid)0000-0002-7911-9949$$aRamón-Arbués, Enrique
000145732 700__ $$aSantos-Sánchez, Jose Angel
000145732 700__ $$0(orcid)0000-0003-1411-524X$$aAguilón-Leiva, Juan José$$uUniversidad de Zaragoza
000145732 700__ $$0(orcid)0000-0002-1894-1621$$aPérez-Calahorra, Sofía$$uUniversidad de Zaragoza
000145732 700__ $$aJuárez-Vela, Raúl
000145732 700__ $$aSufrate-Sorzano, Teresa
000145732 700__ $$aAngulo-Nalda, Beatriz
000145732 700__ $$aGarrote-Cámara, María Elena
000145732 700__ $$aSantolalla-Arnedo, Iván
000145732 700__ $$0(orcid)0000-0002-4753-630X$$aEchániz-Serrano, Emmanuel$$uUniversidad de Zaragoza
000145732 7102_ $$11006$$2255$$aUniversidad de Zaragoza$$bDpto. Fisiatría y Enfermería$$cÁrea Enfermería
000145732 773__ $$g14, 4 (2024), 3007-3022$$pNurs. reports$$tNursing Reports$$x2039-439X
000145732 8564_ $$s746888$$uhttps://zaguan.unizar.es/record/145732/files/texto_completo.pdf$$yVersión publicada
000145732 8564_ $$s3019904$$uhttps://zaguan.unizar.es/record/145732/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada
000145732 909CO $$ooai:zaguan.unizar.es:145732$$particulos$$pdriver
000145732 951__ $$a2024-11-22-11:53:28
000145732 980__ $$aARTICLE