Table 4 Potential strategies to reduce brain dysfunction in ICU patients

Reduce use of benzodiazepines and opioids

Observational studies

[44, 95]

Perform daily sedation stops

RCT

[96, 97]

Use dexmedetomidine (versus benzodiazepines or propofol) as sedative

RCT

[46, 47, 98]

Pain assessment: sedation – analgesia – delirium protocol

Observational studies

[99, 100]

Prevention of metabolic disturbances (severe hypoxemia, fever, dysnatremia(s), prolonged hyperglycemia…)

Observational studies

[4, 54, 57, 59, 101]

Nonpharmacological measures

Sleep protocol

RCT (non-critical care setting)

[102]

Reorientation and cognitively stimulating activities

Rehydration

Use of eyeglasses, magnifying lenses, and hearing aids

Avoid use of physical restraints

Observational studies

[82, 103]

Early mobilization

RCT

[104]