Supervisors info:
Θεόδωρος Κατσούλας, Επίκουρος Καθηγητής, Τμήμα Νοσηλευτικής, ΕΚΠΑ
Παύλος Μυριανθεύς, Καθηγητής, Τμήμα Νοσηλευτικής, ΕΚΠΑ
Ευάγγελος Κωνσταντίνου, Καθηγητής, Τμήμα Νοσηλευτικής, ΕΚΠΑ
Summary:
Introduction - Background: Delirium is a syndrome, that is characterized mainly by acute onset fluctuating course of mental state, attention and consciousness, and is often manifested in hospitalized patients in Intensive Care Unit (ICU).
Aim: The aim of this study was to investigate the role of sedative drugs in the prevention of delirium in ICU patients.
Methodology: A systematic review of bibliography was conducted in Pubmed, Science-Direct, Google Scholar and the National Documentation Center of Greece for studies published by February 2018. The inclusion criteria were the English language, the population to be studied being over the age of 18 years old and a comparison of two or more sedative drugs in the ICU, except of the studies that investigated an antipsychotic drug. Finally, the sample consisted of 24 studies.
Results: The drugs that were used as sedatives to prevent delirium were dexmedetomidine, propofol, midazolam, lorazepam, morphine, remifentanil, fentanyl, ketamine, rivastigmine and ramelteon. The results were not entirely clear, as the conclusions of the investigations were often opposite. It appears that dexmedetomidine, compared to other substances, reduces the occurrence and duration of delirium. Additionally ramelteon seems to have positive results, also.
Conclusions: In order to prevent delirium in the ICU, it has been suggested that the administration of various sedative drugs may result in positive outcomes. Nevertheless, further research is needed in order to find the right substance, with the least possible negative side effects, which will prevent the onset of ICU delirium.
Keywords:
Delirium, Prevent, Intensive Care Unit (ICU), Sedatives