ICU sedation, delirium & recovery
A systematic meta-review of interventions to prevent and manage delirium in the Intensive Care Unit: Part 1 – Pharmacological interventions
Authors' conclusion
Mapped evidence suggests the α2-adrenoceptor agonist drug class (primarily dexmedetomidine), is most likely to be effective at managing delirium in the ICU.
Study context
- Population
- Critically ill adults with, or at risk of, Intensive Care Unit (ICU) delirium56 systematic reviews
- Comparison
- α2-adrenoceptor agonist vs Placebo
- Outcome
- Delirium outcomes:
- Occurrence
- Duration
- Severity
Methodological detailsGRADE certainty mapping, Del-CorS core outcome set, 8 databases searched from inception to 26 September 2023; 3,381 studies screened, 17 reviews included in mapping, Co-interventions, in particular non-pharmacological interventions, often incompletely reported
- GRADE certainty mapping
- Del-CorS core outcome set
- 8 databases searched from inception to 26 September 2023; 3,381 studies screened, 17 reviews included in mapping
- Co-interventions, in particular non-pharmacological interventions, often incompletely reported
Main finding
As reported in the abstract
Delirium occurrence
- α2-adrenoceptor agonists (primarily dexmedetomidine) probably favourable over placebo for preventing or reducing delirium occurrence (moderate to high-certainty evidence; 2 systematic reviews)
- Evidence more variable for other pharmacological comparisons
- 13 reviews with GRADE assessments mapped for delirium outcomes
Further findings
ICU and hospital LOS
- α2-adrenoceptor agonists probably favourable over placebo for reducing ICU and hospital LOS (moderate-certainty evidence; one systematic review)
- 15 reviews mapped for ICU or hospital LOS
ICU and hospital mortality
- ICU mortality: may be little or no difference between dexmedetomidine and non-dexmedetomidine comparator (low certainty); hospital mortality: evidence very uncertain (one systematic review)
- 6 reviews mapped for ICU or hospital mortality
Cognition and emotional distress
- No meta-analyses reported these outcomes
Original publication
A systematic meta-review of interventions to prevent and manage delirium in the Intensive Care Unit: Part 1 – Pharmacological interventions. Crit Care. Published 30 December 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →