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Systematic review and meta-analysis
Earplugs might reduce intensive care unit delirium but quality of evidence is low
  1. Anica C Law1,
  2. Allan J Walkey2
  1. 1Department of Medicine, Beth Israel Deaconess Medical Center, Harvard University School of Medicine, Boston, Massachusetts, USA
  2. 2Department of Medicine, The Pulmonary Center, and Evans Center for Implementation and Improvement Sciences, Boston University School of Medicine, Boston, Massachusetts, USA
  1. Correspondence to: Professor Allan J Walkey, Department of Medicine, The Pulmonary Center, and Evans Center for Implementation and Improvement Sciences, 72 East Concord Street, R-304, Boston University School of Medicine, Boston, MA 02118, USA; alwalkey{at}bu.edu

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Delirium is a form of ‘acute brain dysfunction’ characterised by fluctuations in consciousness, attention and cognitive function.1 Delirium often results from the confluence of multiple factors related to severe acute illness including inflammation, neurotransmitter imbalances, blood-brain barrier disruption, loss of cerebrovascular autoregulation, metabolic insults, oxidative stress, sedative medications and disruption of sleep/wake cycle.2 ,3 It is therefore unsurprising that delirium is highly prevalent during critical illness, affecting up to 80% of patients requiring intensive care, with associated prolonged mechanical ventilation, long-term cognitive impairment and potentially, mortality.4 ,5 Litton et al performed a …

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