Table 2.

Nicotine replacement therapy, agitation, delirium, and associated risk factors

First author, year (ref no.)	Allocation of NRT	NRT dose and form	Time to NRT therapy (days)	Delirium and agitation assessment method	Incidence of delirium or agitation	Frequency and duration of assessment	New psychotropics prescribed
Mayer, 2001 [13]	Treatment response to suspected nicotine withdrawal	21-mg patch	Range 3–11	Subjective	NRT = 100%	–	Sedation, analgesia, or psychotropic use reported n = 4
Honisett, 2001 [14]	Treatment response to suspected nicotine withdrawal	Patch dose not reported	<2	Subjective description of agitation	NRT = 100%	–	Sedation and analgesia n = 1
Seder, 2010 [15]	Clinician discretion	21-mg patch	1–14	Delirium definition provided Assessment method not reported	NRT = 19% No NRT = 7%	–	–
Cartin-Ceba, 2011 [16]	Nurse-driven protocol	21-mg patch (14–21 mg)a	<1	RASS CAM-ICU Use of physical restraints	RASSa NRT = −1 (−4 to 0) No NRT = 0 (−2 to 0) Positive CAM-ICU days NRT = 23% (169/734) No NRT = 13.1% (75/131) Physical restraint days NRT = 38% (281/734) No NRT = 19.5% (112/573)	Worst daily assessment recorded	Fentanyl equivalence mcga NRT = 50 (0–874.9) No NRT = 0 (0–472) P < 0.001 Lorazepam equivalence mga NRT = 0.5 (0–11.5) No NRT = 0 (0–2.3) P < 0.001 More quetiapine in NRT group More dexmedetomidine and haloperidol in no NRT group
Gillies, 2012 [18]	Clinician discretion	20-mg patch (range 10–30 mg)	2.3 (1.5–5.0)a	Validated chart review with prescription of ≥2 anti-agitation drugs as surrogate marker	NRT = 25.7% No NRT = 7.1%	Once per patient	NRT = 25.7% No NRT = 7.1% Required ≥2 anti-agitation drugs P < 0.001
Pathak, 2013 [17]	Randomised	NRT = 21-mg patch No NRT = placebo	≤2	Analgesia, sedation, and days on ventilator used as surrogate marker	Mechanical ventilation daysb NRT = 1.9 ± 3.7 No NRT = 3.5 ± 5.3	–	Sedation (days) NRT = 1.4 No NRT = 2.7 Analgesia (days) NRT = 1.1 No NRT = 2.1

^aMedian (interquartile range)

^bMean ± standard deviation