Efficacy of Intranasal Insulin in the prophylaxis of ICU Delirium: A Single center double blined prospective randomized trial

Delirium is a sudden and severe state of confusion characterized by fluctuating disruptions in cognitive function and attention.The prevalence of delirium varies widely in the intensive care unit affecting 11% and 83% of patients. Its occurence is associated with increased mortality and prolonged ICU stays.Prevention and management remains a tough problem because of side effects and limited effiacy of treatment options.No evidence based pharmacological therapies have been proven efficacious in treatment of delirium.

Intranasal insulin has recently emerged as a promising approach for preventing and treating perioperative neurocognitive disorders, showing effectiveness without reported side effects. Intranasal insulin administration at doses of 160 units has demonstrated improvements in memory function and brain metabolism in patients with cognitive dysfunction and delirium without causing hypoglycemia. it bypasses the blood brain barrier and elevates insulin levels in the cerebrospinal fluid without entering the bloodstream or causing systemic metabolic effects.

The replicability and applicability of these proposed benefits of intranasal insulin is still unclear in critical care.in this study, we try to answer if intranasal insulin reduces the prevalence of delirium in a population of critically ill patients compared with usual care