Dexmedetomidine for the Prevention of Delirium in Critically Ill Patients - A Protocol for a Systematic Review

Acta Anaesthesiol Scand. 2019 Apr;63(4):540-548. doi: 10.1111/aas.13313. Epub 2019 Jan 23.

Abstract

Background: Delirium is a common complication in critically ill patients and carries an increased risk of mortality and morbidity. Dexmedetomidine can potentially prevent delirium by diminishing predisposing factors. The evidence regarding the use of dexmedetomidine in preventing delirium is conflicting. This protocol aims to identify the beneficial and harmful effects of dexmedetomidine in the prevention of delirium.

Methods: This protocol uses the recommendations of the Cochrane Collaboration, the Preferred Report Items of Systematic Reviews with Meta-Analysis Protocols, and the eight-step assessment procedure suggested by Jakobsen and colleagues. We wish to assess in critically ill patients, if dexmedetomidine versus placebo can reduce the incidence of delirium and improve clinical outcomes. We will include all randomised trials assessing the use of dexmedetomidine in the prevention of delirium. To identify trials, we will search the Cochrane Central Register of Controlled Trials, Medical Literature Analysis and Retrieval System Online, Excerpta Medica database, Latin American and Caribbean Health Sciences Literature, Science Citation Index Expanded on Web of Science, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, Chinese Science Journal Database, and BIOSIS. Two authors will screen the literature and extract data. We will use the Cochrane risk of bias tool to evaluate trials. Extracted data will be analysed using Review Manager 5 and Trial Sequential Analysis. We will create a "Summary of Findings"-table in which we will present our primary and secondary outcomes. We will assess the quality of evidence using GRADE.

Discussion: This systematic review can potentially aid clinicians in decision-making and benefit the many critically ill patients at risk of delirium.

Keywords: Delirium; Systematic review registration: CRD42018115560; dexmedetomidine; meta-analysis; systematic review; trial sequential analysis.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Critical Illness*
  • Delirium / etiology
  • Delirium / prevention & control*
  • Dexmedetomidine / therapeutic use*
  • Humans
  • Hypnotics and Sedatives / therapeutic use*
  • Meta-Analysis as Topic*
  • Research Design
  • Systematic Reviews as Topic*

Substances

  • Hypnotics and Sedatives
  • Dexmedetomidine