Effect of early cognitive interventions on delirium in critically ill patients: a systematic review.
Effet des interventions cognitives précoces sur le delirium chez les patients en état critique : une revue systématique.
Cognitive interventions
Delirium
Delirium prevention
ICU delirium
Ocupational therapist
Journal
Canadian journal of anaesthesia = Journal canadien d'anesthesie
ISSN: 1496-8975
Titre abrégé: Can J Anaesth
Pays: United States
ID NLM: 8701709
Informations de publication
Date de publication:
Aug 2020
Aug 2020
Historique:
received:
27
06
2019
accepted:
09
03
2020
revised:
10
02
2020
pubmed:
26
4
2020
medline:
20
2
2021
entrez:
26
4
2020
Statut:
ppublish
Résumé
A systematic review of the literature was conducted to determine the effects of early cognitive interventions on delirium outcomes in critically ill patients. Search strategies were developed for MEDLINE, EMBASE, Joanna Briggs Institute, Cochrane, Scopus, and CINAHL databases. Eligible studies described the application of early cognitive interventions for delirium prevention or treatment within any intensive care setting. Study designs included randomized-controlled trials, quasi-experimental trials, and pre/post interventional trials. Two reviewers independently extracted data and assessed risk of bias using Cochrane methodology. Four hundred and four citations were found. Seven full-text articles were included in the final review. Six of the included studies had an overall serious, high, or critical risk of bias. After application of cognitive intervention protocols, a significant reduction in delirium incidence, duration, occurrence, and development was found in four studies. Feasibility of cognitive interventions was measured in three studies. Cognitive stimulation techniques were described in the majority of studies. The study of early cognitive interventions in critically ill patients was identified in a small number of studies with limited sample sizes. An overall high risk of bias and variability within protocols limit the utility of the findings for widespread practice implications. This review may help to promote future large, multi-centre trials studying the addition of cognitive interventions to current delirium prevention practices. The need for robust data is essential to support the implementation of early cognitive interventions protocols. RéSUMé: OBJECTIF : Une revue systématique de la littérature a été réalisée afin de déterminer les effets des interventions cognitives précoces sur l’évolution du delirium chez les patients en état critique. Des stratégies de recherche ont été mises au point pour explorer les bases de données MEDLINE, EMBASE, Joanna Briggs Institute, Cochrane, Scopus et CINAHL. Les études éligibles devaient décrire l’application d’interventions cognitives précoces pour la prévention ou le traitement du delirium dans un contexte de soins intensifs. Les types d’études retenues incluaient des études randomisées contrôlées, des études quasi expérimentales et des études pré-/post-interventionnelles. En se fondant sur la méthodologie Cochrane, deux réviseurs ont extrait les données et évalué le risque de biais de manière indépendante. Quatre cent quatre citations ont été extraites. Sept articles ont été retenus pour le compte rendu final. Six des études incluses présentaient un risque global de biais majeur, élevé ou critique. Après l’application des protocoles d’interventions cognitives, quatre études ont noté une réduction significative de l’incidence, de la durée, de la survenue et de l’apparition de delirium. Trois études ont mesuré la faisabilité des interventions cognitives. La majorité des études décrivaient les techniques de stimulation cognitive. Nous sommes parvenus à identifier quelques études ayant des tailles d’échantillon limitées décrivant des interventions cognitives précoces chez les patients en état critique. Un risque global élevé de biais et de variabilité au sein des protocoles limite toutefois l’utilité de ces observations pour leurs applications dans la pratique. Ce compte rendu pourrait susciter l’intérêt de chercheurs pour réaliser des études d’envergure et multicentriques examinant l’ajout d’interventions cognitives aux pratiques actuelles de prévention du delirium. Le besoin de données robustes est crucial pour soutenir la mise en œuvre de protocoles précoces d’interventions cognitives.
Autres résumés
Type: Publisher
(fre)
RéSUMé: OBJECTIF : Une revue systématique de la littérature a été réalisée afin de déterminer les effets des interventions cognitives précoces sur l’évolution du delirium chez les patients en état critique.
Identifiants
pubmed: 32333291
doi: 10.1007/s12630-020-01670-z
pii: 10.1007/s12630-020-01670-z
pmc: PMC7222136
doi:
Types de publication
Journal Article
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
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