Non-Pharmacological Interventions for Delirium in Intensive Care Unit Patients

Abstract

Introduction: ICU delirium affects up to 80% of mechanically ventilated patients and is linked to prolonged stay and cognitive decline. Non-pharmacological strategies are preferred but evidence synthesis is lacking.
Methods: This literature review searched CINAHL, Scopus, and Web of Science (2010–2023) for interventional studies on non-pharmacological delirium prevention in adult ICUs. Included interventions: early mobilization, family engagement, sleep protocols, and reorientation. Outcome: delirium incidence/duration measured by CAM-ICU or ICDSC.
Results: Twenty-three studies (n=4,105) met criteria. Early mobilization reduced delirium duration by 2.1 days (p<0.001). Multicomponent protocols (e.g., eICU checklist) decreased incidence from 32% to 19%. Sleep promotion (earplugs, light reduction) alone showed no significant effect. Family presence shortened delirium by 1.4 days.
Discussion: Bundled interventions targeting modifiable risk factors are more effective than single strategies. Early mobilization likely reduces neuroinflammation and improves circadian rhythm. Heterogeneity in compliance and ICU staffing levels affects outcomes.
Conclusions: Multicomponent non-pharmacological programs reduce ICU delirium burden. Implementation requires nurse-led protocols and structural support for mobility.