To evaluate whether delirium-directed interventions improve long-term cognitive outcomes in adult ICU survivors.
Key Findings:
Four randomized clinical trials met inclusion criteria, with one additional trial reviewed for contextual evidence.
Two trials evaluated pharmacological treatment using antipsychotic agents, while two trials focused on non-pharmacological rehabilitation-based interventions.
Rehabilitation-based interventions showed feasibility and preliminary signals of improved executive function.
Antipsychotic treatment did not improve global cognition, functional status, or quality of life at 3 or 12 months.
Interpretation:
Rehabilitation-based delirium-directed interventions show potential benefits for long-term cognitive outcomes, while antipsychotic treatment does not provide sustained cognitive benefits.
Limitations:
The evidence base consists of only three distinct randomized comparisons.
There is a need for larger, cognition-powered trials with harmonized survivorship endpoints.
Conclusion:
Rehabilitation-based interventions may improve long-term cognitive outcomes in ICU survivors, contrasting with the lack of benefit from antipsychotic treatments.
