• Journal of critical care · Apr 2022

    Randomized Controlled Trial

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

    • Tássia Nery Faustino, Nathália Almeida Suzart, Rebecca Neves Dos Santos Rabelo, Juliete Lima Santos, Gyuliana Santana Batista, Yasmin Seixas de Freitas, Danilo Alves Saback, Nabila Monalisa Mendes Dantas Sales, Brandao BarretoBrunaBPrograma 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., and Dimitri Gusmao-Flores.
    • 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.
    • J Crit Care. 2022 Apr 1; 68: 114-120.

    PurposeDelirium 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 MethodsThis 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.ResultsThe 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.ConclusionsCombined non-pharmacological interventions reduced delirium in critically ill patients, compared to standard care.Trial RegistrationBrazilian Registry of Clinical Trials (ReBEC), Identifier RBR-6xq95s, October 03, 2018.Copyright © 2022 Elsevier Inc. All rights reserved.

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