Background: The prevalence of delirium in intensive care unit (ICU) patients is high. Delirium has been associated with ICU morbidity and mortality including more ventilator days, longer ICU stay, worse long-term mortality, and cognitive impairment. The burden of delirium for patients, relatives and societies is, therefore, likely to be significant. Today systematic reviews of randomised clinical trials are produced in large scales making it difficult to get a quick evidence-based insight and overview. A preliminary search identified several systematic reviews investigating the effects of pharmacological interventions for the management and prevention of delirium in ICU patients. The conclusions of the reviews showed conflicting results. Despite this unclear evidence, antipsychotics and in particular haloperidol is often the recommended pharmacological intervention for delirium in ICU patients.
Objectives: The objective of this overview of systematic reviews is to assess critically the evidence of systematic reviews of randomised clinical trials on the effect of pharmacological management and prevention of delirium in ICU patients.
Methods: We will search for systematic reviews in the following databases: the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, PsycINFO, Science Citation Index, Latin American and Caribbean Health Sciences Literature (LILACS), Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Allied and Complementary Medicine Database.
Two authors will independently select references for inclusion using Covidence, extract data and assess the methodological quality of the included systematic reviews using the ROBIS (risk of bias in systematic reviews) tool. Any disagreement will be resolved by consensus. We will present data as a narrative synthesis and summarise the main results of the included systematic reviews. In addition, we will present an overview of the bias risk assessment of the systematic reviews. For systematic reviews deemed to be low risk of bias, we will assess risk of bias in the included trials. Our conclusion will be based on systematic reviews assessed low risk of bias.