A. Nonpharmacologic prevention and treatment |
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Single component |
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Should a single-component, nonpharmacologic strategy not solely focused on sleep improvement or early mobilization (vs. no such strategy) be used to reduce delirium in critically ill adults? |
Committee suggests not using bright light therapy to reduce delirium in critically ill adults (conditional recommendation, moderate quality of evidence). |
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Multicomponent |
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Should a multicomponent, nonpharmacologic strategy (vs. no such strategy) be used to reduce delirium in critically ill adults? |
Committee suggests using a multicomponent, nonpharmacologic intervention that is focused on (but not limited to) reducing modifiable risk factors for delirium, improving cognition, and optimizing sleep, mobility, hearing, and vision in critically ill adults (conditional recommendation, low quality of evidence). |
B. Pharmacologic prevention and treatment |
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Should a pharmacologic agent (vs. no use of this agent) be used to “prevent” delirium in all critically ill adults? |
Committee suggests not using haloperidol, an atypical antipsychotic, dexmedetomidine, a HMG-CoA reductase inhibitor (i.e., statin), or ketamine to prevent delirium in all critically ill adults (conditional recommendation, very low to low quality of evidence). |
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Should a pharmacologic agent (vs. no use of this agent) be used to “treat subsyndromal delirium” in all critically ill adults with subsyndromal delirium? |
Committee suggests not using haloperidol or an atypical antipsychotic to treat sub-syndromal delirium in critically ill adults (conditional recommendation, very low to low quality of evidence). |
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Should a pharmacologic agent (vs. no use of this agent) be used to treat delirium in all critically ill adults with delirium? |
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1. Antipsychotic/statin |
Committee suggests not routinely using haloperidol, an atypical antipsychotic, or a HMG-CoA reductase inhibitor (i.e., a statin) to treat delirium (conditional recommendation, low quality of evidence). |
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2. Dexmedetomidine |
Committee suggests using dexmedetomidine for delirium in mechanically ventilated adults where agitation precludes weaning/extubation (conditional recommendation, low quality of evidence). |