Table 4.

Potential strategies to reduce brain dysfunction in ICU patients

Pharmacological measures		Type of study	References
	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]

RCT randomized controlled trial.