Current controversies and future perspectives on treatment of intensive care unit delirium in adults

Table 2 Selected evidence-based research on pharmacological management of delirium in intensive care unit

Ref.	Analysis	Findings
Burry et al[41]	Cochrane analysis	In non-ICU patients there is a poor evidence about the efficacy of typical, or SGAs, on the duration of delirium, discharge time, or HRQoL
Lonergan et al[42]	Cochrane analysis	Low dose haloperidol may be effective against POD, although with greater incidence of side effects when compared to the SGAs; Limitation: analysis based on small studies of limited scope
Serafim et al[43]	Systematic review	Prophylactic use of haloperidol, may be useful for reducing the prevalence of ICU-D
Herling et al[44]	Cochrane analysis	No difference proved between haloperidol and placebo for preventing ICU-D
Tao et al[53]	Meta-analysis	Administration of dexamethasone was associated with a reduction in delirium after on-pump cardiac surgery; Limitation: studies at a high risk of bias
Barbateskovic et al[45]	Systematic overview of reviews and meta-analyses	Pharmacological strategies for prevention or management of ICU-D is poor, or sparse
Chen et al[46]	Cochrane analysis	No evidence on the preventive and therapeutic role of dexmedetomidine against ICU-D and its outcome
Liu et al[47]	Meta-analysis	Dexmedetomidine may reduce delirium and duration of MV in patients after cardiac surgery when compared with propofol
Pasin et al[48]	Meta-analysis	Dexmedetomidine may reduce delirium also in patients undergoing non-invasive ventilation
Tampi et al[50]	Systematic review	Anticholinesterase inhibitors have no benefit against ICU-D prevention, or treatment
Lonergan et al[24]	Cochrane analysis	There is no evidence to support the use of BDZs in the treatment of non-alcohol withdrawal related delirium

ICU: Intensive care unit; SGAs: Second generation antipsychotics; LOS: Length of stay; HRQoL: Health-related quality of life; POD: Postoperative delirium; MV: Mechanical ventilation; BDZs: Benzodiazepines.