This systematic review and meta-analysis examined the prevalence of delirium in ARDS patients, its impact on clinical outcomes, and the association between ARDS and delirium development — drawing from 13 studies (n=10,052) identified via PubMed, Scopus, and Web of Science up to September 2024.
Pooled delirium prevalence in ARDS patients was 41% (95% CI: 23–58%); the risk of delirium was higher in ARDS vs. controls but did not reach statistical significance (RR 1.34, 95% CI: 0.63–2.83). Delirium was consistently linked to prolonged ICU stay, longer mechanical ventilation, and worse clinical outcomes.
- Substantial heterogeneity across studies limits the precision of pooled estimates. - The primary association (ARDS vs. controls for delirium risk) was not statistically significant, so causality cannot be established. - Only 13 studies met inclusion criteria, which may limit generalizability.
Given a ~41% delirium rate in ARDS patients, clinicians should proactively screen for delirium and apply bundle-based strategies: minimize sedation, start early mobilization, and provide psychological support. A multidisciplinary team approach is key to reducing delirium-related complications such as prolonged ventilation and ICU stay.
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