The Effects of Dexmedetomidine on Preventing/Decreasing Severity of Delirium When Given to Surgical Intensive Care Unit Patients: A Systematic Review of Randomized Control Trials

The purpose of this systematic review was to integrate research evidence from studies published from 2010 to 2020 on the relationship between administration of dexmedetomidine and severity/prevalence of postprocedural delirium in patients in the surgical intensive care unit. In this review, clinical trial studies were recovered by searching the MEDLINE Complete and PubMed databases and utilizing MeSH terminology search. The MeSH terms utilized to search for applicable articles on PubMed included: “intensive care units” or “critical care” or “critical care nursing”, and “delirium”, “dexmedetomidine”, and “surgical procedures, operative”. On MEDLINE Complete, the search terms utilized were “ICU or intensive care unit or critical care” and “dexmedetomidine” and “delirium” and “surgical procedures, operative”. Search limiters applied to both databases included English language, and peer-reviewed journal articles from 2009-2020. Overall, 4 articles were included in this review and the data and dexmedetomidine was found to reduce incidence of delirium in patients who had received surgery in 2 studies. In the other study conducted, there was no statistical significance between delirium incidence between the placebo and experimental group; and the last study was a 3-year follow-up of another one of the studies explored in this review. Regarding secondary outcomes, significantly lower pain scores were reported in all three studies. Other secondary outcomes related to dexmedetomidine administration that were found to differ significantly in the studies include significantly lower need for pain rescue, shorter time to extubation, lower pneumonia incidence, and higher amount of discharges within 7 days. Regarding long-term follow up, patients in the dexmedetomidine group were found to have higher scores in cognition and higher 6 month, 1-year, and 2-year survival rates