Melatonin intervention to prevent delirium in the intensive care units: a systematic review and meta-analysis of randomized controlled trials

Frontiers in Endocrinology

Endocrinology

Yuan Yang¹  Jianlin Shao¹  Weihua Zhu²  Jinxi Yue²  Gang Wang²  Qi Bao²  Xiaohong Wan²  Yushan Duan²  Linjun Wan² 

[1] Department of Anesthesiology, The First Affiliated Hospital, Kunming Medical University, Kunming, China;Department of Critical Care Medicine, The Second Affiliated Hospital, Kunming Medical University, Kunming, China;

关键词: melatonin;    delirium;    intensive care;    meta-analysis;    randomized controlled trials;   

DOI  :  10.3389/fendo.2023.1191830

 received in 2023-03-22, accepted in 2023-07-07,  发布年份 2023

来源: Frontiers

【 摘 要 】

ObjectiveTo determine the preventive effect of melatonin on delirium in the intensive care units.MethodsWe conducted a systematic search of the PubMed, Cochrane Library, Science, Embase, and CNKI databases, with retrieval dates ranging from the databases’ inception to September 2022. Controlled trials on melatonin and placebo for preventing delirium in the intensive care units were included. The meta-analysis was performed using Review Manager software (version 5.3) and Stata software (version 14.0).ResultsSix studies involving 2374 patients were included in the meta-analysis. The results of the meta-analysis showed that melatonin did not reduce the incidence of delirium in ICU patients (odds ratio [OR]: 0.71; 95% confidence interval [CI]: 0.46 to 1.12; p = 0.14). There was a strong hetero-geneity between the selected studies (I2 = 74%). Subgroup analysis results showed that melatonin reduced the incidence of delirium in cardiovascular care unit (CCU) patients (OR: 0.52; 95% CI: 0.37 to 0.73; p=0.0001), but did not in general intensive care unit (GICU) patients (OR: 1.14; 95% CI: 0.86 to 1.50; p=0.35). In terms of the secondary outcomes, there were no significant differences in all-cause mortality (OR: 0.85; 95% CI: 0.66 to 1.09; p=0.20), length of ICU stay (mean difference [MD]: 0.33; 95% CI: -0.53 to 1.18; p=0.45), or length of hospital stay (MD: 0.51; 95% CI: -1.17 to 2.19; p=0.55).ConclusionMelatonin reduced the incidence of delirium in CCU patients, but did not significantly reduce the incidence of delirium in GICU patients.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42022367665.

【 授权许可】

Unknown   
Copyright © 2023 Duan, Yang, Zhu, Wan, Wang, Yue, Bao, Shao and Wan