• Kara J Pavone, Pamela Z Cacchione, Rosemary C Polomano, LoriAnn Winner, and Peggy Compton.
• University of Pennsylvania, School of Nursing, 418 Curie Blvd, Philadelphia, PA 19104, United States. Electronic address: kpavone@nursing.upenn.edu.
• Heart Lung. 2018 Nov 1; 47 (6): 591-601.

AbstractDelirium, an acute change in cognition and attention not secondary to a pre-existing condition or dementia, affects nearly 40,000 hospitalized older adults in the United States every day. Delirium is associated with increased healthcare costs of $16,303 to $64,421 per patient. To date, no single pharmacological intervention is effective in preventing or treating delirium in critically ill patients. Evidence suggests the alpha-2 agonist, dexmedetomidine, may reduce or prevent delirium. An integrative review examined whether dexmedetomidine was associated with a lower incidence of delirium compared to other analgesic and sedation strategies. PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guided this review and 16 publications met quality criteria for inclusion. These studies support that postoperative administration of dexmedetomidine may reduce delirium in patients, particularly following cardiac surgery. Further research is needed to determine the benefits of dexmedetomidine in patients on mechanical ventilation and optimal timing and duration of administration.Copyright © 2018 Elsevier Inc. All rights reserved.

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