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Prevention of Delirium in ICU Using Multimodal Interventions

Not Applicable
Recruiting
Conditions
Intensive Care Unit Delirium
Interventions
Other: Multimodal therapy for prevention of delirium
Registration Number
NCT05950958
Lead Sponsor
Seoul National University Hospital
Brief Summary

This study was designed to evaluate the impact of non-pharmacological multimodal interventions including ongoing orientation, sensory correction, setting of familiar circumstance and promotion of sleep enviromnet for prevention of delirium in intensive care unit.

Detailed Description

Delirium significantly increases not only the length of the intensive care unit stay and overall mortality, but also the likelihood of persistant cognitive impairment after recovery. However there is no definitive treatment for delirium, thereby it is important to prevent delirium before it occur. Researches also have focused on the prevention of delirium or the reduction of duration of delirium.

Several studies evaluated the effect of non-pharmacological treatment, such as improvement of orientation, prevention of sensory deprivation, active pain control and prevention of dehydration, to reduce the occurrence of delirium and the results were inconsistent depending on the patients included. However, there have been no randomized clinical trials that have tested the effect of prevention of delirium by applying non-pharmacological multimodal approaches in the intensive care unit for Korean patients.

A randomized controlled trial was planned to evaluate the impact of on-pharmacological multimodal interventions including ongoing orientation, sensory correction, setting of familiar circumstance and promotion of sleep enviromnet for prevention of delirium in intensive care unit in Korea.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
196
Inclusion Criteria
  • Adult patients over 50 years who are expected to spend more than 24 hours in the intensive care unit
Exclusion Criteria
  • Patients who developed delirium before entering the intensive care unit
  • Patients with cognitive impairment
  • Patients who have hearing or vision deficits, or have difficulty in communication
  • Patients who are expected to die within 24 hours or do not want life-sustaining treatment

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Multimodal therapy groupMultimodal therapy for prevention of deliriumContinuous regional cerebral oxygen saturation and processed electroencephalogram (EEG) are monitored. Multimodal therapy with conventional care are provided to prevent delirium. Ongoing orientation: 3 times per day Sensory correction: the hearing device and the glasses are supplied. Cognitive stimulation: a portable monitor is used to provide visual stimulation, and a directional speaker is used to avoid disturbing the alarm of the patient's life supportimng system. Sleep promotion: the lights are turned off from 10 pm to 7 am, and the indirect light source is used if necessary.
Primary Outcome Measures
NameTimeMethod
Number of patients with deliriumFrom ICU admission up to day 28 or discharge from ICU or death

Delirium assessed by Confusion Assessment Method for the ICU (CAM-ICU)

Secondary Outcome Measures
NameTimeMethod
Accidental extubation or disconnection of treatment devicesFrom ICU admission up to day 28 or discharge from ICU or death

Accidental extubation or disconnection of treatment devices

Delirium-free daysFrom ICU admission up to day 28 or discharge from ICU or death

Delirium assessed by Confusion Assessment Method for the ICU (CAM-ICU)

ICU and hospital length of stayFrom ICU admission up to day 28 or discharge from ICU or death

Duration of ICU and hospital stay

Severity of deliriumFrom ICU admission up to day 28 or discharge from ICU or death

Confusion Assessment Method for the ICU-7 (CAM-ICU-7) delirium severity score

Trial Locations

Locations (1)

Seoul National University Hospital

🇰🇷

Seoul, Korea, Republic of

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