A eficácia da melatonina na prevenção do delirium em pacientes hospitalizados: uma revisão integrativa
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Jun 25, 2022
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Resumo
Objetivo: Elucidar a eficácia da melatonina na prevenção do delirium em pacientes adultos hospitalizados. Métodos: Trata-se de um estudo de abordagem qualitativa, por meio de uma revisão integrativa de literatura, no qual as bases de dados utilizadas foram: PubMed, Directory of Open Access Journals (DOAJ) e Cochrane Library (CL). Os descritores escolhidos, intermediados pelo operador booleano “AND”, para a busca dos artigos nas plataformas foram “melatonin”, “sleep” e “delirium”. Resultados: Após a aplicação de critérios de inclusão e exclusão, restaram 18 artigos selecionáveis. Dos artigos analisados, 12 não encontraram resultados estatisticamente significativos que justifiquem o uso da melatonina como terapêutica preventiva para o delirium em pacientes hospitalizados; 2 apontaram a capacidade de aumentar a qualidade do sono. Considerações finais: Não há um consenso estabelecido sobre os benefícios da melatonina na prevenção do delirium. Ademais, não existem evidências suficientes para sustentar sua utilização. Novos estudos devem ser conduzidos.
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Como Citar
GoulartT. de L., MoraesM. de S., SilvaC. M. A. e, IostA. R. J., CarvalhoD. B. de, FerreiraV. L., & Figueiredo JúniorH. S. de. (2022). A eficácia da melatonina na prevenção do delirium em pacientes hospitalizados: uma revisão integrativa. Revista Eletrônica Acervo Médico, 10, e10410. https://doi.org/10.25248/reamed.e10410.2022
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Referências
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2. AL-AAMA T, et al. Melatonin decreases delirium in elderly patients: a randomized, placebo-controlled trial. International journal of geriatric psychiatry, 2011; 26: 687–694.
3. AMERICAN PSYCHIATRIC ASSOCIATION. Manual diagnóstico e estatístico de transtornos mentais: DSM-5. Porto Alegre: Artmed, 2014; 948p.
4. ARTEMIOU P, et al. Melatonin treatment in the prevention of postoperative delirium in cardiac surgery patients. Kardiochir Torakochirurgia Pol, 2015; 12(2): 126-33.
5. BANDYOPADHYAY A, et al. Efficacy of melatonin in prevention of delirium in critically ill adults: a Randomised Controlled Trial. Intensive care medicine experimental, 2021; 9(1): 20-27.
6. BAUMGARTNER L, et al. Effectiveness of Melatonin for the Prevention of Intensive Care Unit Delirium. Pharmacotherapy, 2019; 39(3): 280-287.
7. BELLAPART J, et al. Effect of Exogenous Melatonin Administration in Critically Ill Patients on Delirium and Sleep: A Randomized Controlled Trial. Crit Care Res Pract, 2020; 2020: 395.
8. CHEN S, et al. Exogenous Melatonin for Delirium Prevention: a Meta-analysis of Randomized Controlled Trials. Mol Neurobiol, 2016; 53(6): 4046-4053.
9. CUSIMANO JM, et al. Factors Associated with Delirium in Surgical Intensive Care Unit Patients Treated With Supplemental Melatonin: A Case-Cohort Study. Clin Neuropharmacol, 2019; 42(3): 67-72.
10. DE JONGHE A, et al. Effect of melatonin on incidence of delirium among patients with hip fracture: a multicentre, double-blind randomized controlled trial. CMAJ, 2014; 186(14): 547-56.
11. DIANATKHAH M, et al. Evaluating the Potential Effect of Melatonin on the post-Cardiac Surgery Sleep Disorder. J Tehran Heart Cent, 2015; 10(3): 122-128.
12. FADAYOMI AB, et al. A Systematic Review and Meta-Analysis Examining the Impact of Sleep Disturbance on Postoperative Delirium. Crit Care Med, 2018; 46(12): 1204-1212.
13. GANDOLFI JV, et al. The Effects of Melatonin Supplementation on Sleep Quality and Assessment of the Serum Melatonin in ICU Patients: A Randomized Controlled Trial. Crit Care Med, 2020; 48(12): 1286-1293.
14. HANANIA M, KITAIN E. Melatonin for treatment and prevention of postoperative delirium. Anes. Analg.,2002;94(2):338-9.
15. HATTA K, et al. Preventive effects of ramelteon on delirium: a randomized placebo-controlled trial. JAMA psychiatry, 2014; 71: 397–403.
16. HOSSEINI KF, et al. Effect of Melatonin on Incidence Rate of Delirium in Elderly Patients Undergoing Open-Heart Surgery without a Pump: A Clinical Trial. Elderly Health Journal, 2019; 5(1): 32-39.
17. HUANG HW, et al. Effect of oral melatonin and wearing earplugs and eye masks on nocturnal sleep-in healthy subjects in a simulated intensive care unit environment: which might be a more promising strategy for ICU sleep deprivation? Critical care, 2015; 19: 124.
18. INOUYE SK, et al. Delirium in elderly people. Lancet, 2014; 383(9920): 911-22.
19. JAISWAL SJ, et al. Melatonin and Sleep in Preventing Hospitalized Delirium: A Randomized Clinical Trial. Am J Med, 2018; 131(9): 1110-1117.
20. KHAING K, NAIR BR. Melatonin for delirium prevention in hospitalized patients: A systematic review and meta-analysis. J Psychiatr Res, 2021; 133: 181-190.
21. LANGE PW, et al. Results from a double blinded, randomised, placebo-controlled, feasibility trial of melatonin for the treatment of delirium in older medical inpatients. Intern Med J, 2021; 51(1): 33-41.
22. LAWLOR PG, et al. Melatonin to prevent delirium in patients with advanced cancer: a double blind, parallel, randomized, controlled, feasibility trial. BMC Palliat Care, 2020; 19(1): 163.
23. LEWANDOWSKA K, et al. The role of melatonin and melatonin receptor agonist in the prevention of sleep disturbances and delirium in intensive care unit - a clinical review. Sleep Med, 2020; 69: 127-134.
24. MISTRALETTI G, et al. Melatonin reduces the need for sedation in ICU patients: a randomized controlled trial. Minerva Anestesiol. 2015; 81(12): 1298-310.
25. PEREIRA AS, et al. Metodologia da pesquisa científica. Santa Maria: Universidade Federal de Santa Maria, 2018; 119p.
26. PISANI MA, D'AMBROSIO C. Sleep and Delirium in Adults Who Are Critically Ill: A Contemporary Review. Chest, 2020; 157(4): 977-984.
27. RAMYA K, et al. Melatonin to prevent delirium in organophosphorus compound poisoning patients: a double-blind randomized control trial. Indian journal of critical care medicine, 2015; 19(13): S8-S9.
28. ROMERO N, et al. Evaluation of Delirium in Critically Ill Patients Prescribed Melatonin or Ramelteon. Ann Pharmacother, 2021; 55(11): 1347-1354.
29. SCHOLTENS RM, et al. Plasma melatonin levels in hip fracture patients with and without delirium: A confirmation study. Mech Ageing Dev, 2017; 167: 1-4.
30. SHA J, et al. Melatonin in the management of delirium in the elderly: double-blind randomized controlled pilot trial. Respirology, 2019; 24: 199.
31. SULTAN SS. Assessment of role of perioperative melatonin in prevention and treatment of postoperative delirium after hip arthroplasty under spinal anesthesia in the elderly. Saudi J Anaesth, 2010; 4(3): 169-73.
2. AL-AAMA T, et al. Melatonin decreases delirium in elderly patients: a randomized, placebo-controlled trial. International journal of geriatric psychiatry, 2011; 26: 687–694.
3. AMERICAN PSYCHIATRIC ASSOCIATION. Manual diagnóstico e estatístico de transtornos mentais: DSM-5. Porto Alegre: Artmed, 2014; 948p.
4. ARTEMIOU P, et al. Melatonin treatment in the prevention of postoperative delirium in cardiac surgery patients. Kardiochir Torakochirurgia Pol, 2015; 12(2): 126-33.
5. BANDYOPADHYAY A, et al. Efficacy of melatonin in prevention of delirium in critically ill adults: a Randomised Controlled Trial. Intensive care medicine experimental, 2021; 9(1): 20-27.
6. BAUMGARTNER L, et al. Effectiveness of Melatonin for the Prevention of Intensive Care Unit Delirium. Pharmacotherapy, 2019; 39(3): 280-287.
7. BELLAPART J, et al. Effect of Exogenous Melatonin Administration in Critically Ill Patients on Delirium and Sleep: A Randomized Controlled Trial. Crit Care Res Pract, 2020; 2020: 395.
8. CHEN S, et al. Exogenous Melatonin for Delirium Prevention: a Meta-analysis of Randomized Controlled Trials. Mol Neurobiol, 2016; 53(6): 4046-4053.
9. CUSIMANO JM, et al. Factors Associated with Delirium in Surgical Intensive Care Unit Patients Treated With Supplemental Melatonin: A Case-Cohort Study. Clin Neuropharmacol, 2019; 42(3): 67-72.
10. DE JONGHE A, et al. Effect of melatonin on incidence of delirium among patients with hip fracture: a multicentre, double-blind randomized controlled trial. CMAJ, 2014; 186(14): 547-56.
11. DIANATKHAH M, et al. Evaluating the Potential Effect of Melatonin on the post-Cardiac Surgery Sleep Disorder. J Tehran Heart Cent, 2015; 10(3): 122-128.
12. FADAYOMI AB, et al. A Systematic Review and Meta-Analysis Examining the Impact of Sleep Disturbance on Postoperative Delirium. Crit Care Med, 2018; 46(12): 1204-1212.
13. GANDOLFI JV, et al. The Effects of Melatonin Supplementation on Sleep Quality and Assessment of the Serum Melatonin in ICU Patients: A Randomized Controlled Trial. Crit Care Med, 2020; 48(12): 1286-1293.
14. HANANIA M, KITAIN E. Melatonin for treatment and prevention of postoperative delirium. Anes. Analg.,2002;94(2):338-9.
15. HATTA K, et al. Preventive effects of ramelteon on delirium: a randomized placebo-controlled trial. JAMA psychiatry, 2014; 71: 397–403.
16. HOSSEINI KF, et al. Effect of Melatonin on Incidence Rate of Delirium in Elderly Patients Undergoing Open-Heart Surgery without a Pump: A Clinical Trial. Elderly Health Journal, 2019; 5(1): 32-39.
17. HUANG HW, et al. Effect of oral melatonin and wearing earplugs and eye masks on nocturnal sleep-in healthy subjects in a simulated intensive care unit environment: which might be a more promising strategy for ICU sleep deprivation? Critical care, 2015; 19: 124.
18. INOUYE SK, et al. Delirium in elderly people. Lancet, 2014; 383(9920): 911-22.
19. JAISWAL SJ, et al. Melatonin and Sleep in Preventing Hospitalized Delirium: A Randomized Clinical Trial. Am J Med, 2018; 131(9): 1110-1117.
20. KHAING K, NAIR BR. Melatonin for delirium prevention in hospitalized patients: A systematic review and meta-analysis. J Psychiatr Res, 2021; 133: 181-190.
21. LANGE PW, et al. Results from a double blinded, randomised, placebo-controlled, feasibility trial of melatonin for the treatment of delirium in older medical inpatients. Intern Med J, 2021; 51(1): 33-41.
22. LAWLOR PG, et al. Melatonin to prevent delirium in patients with advanced cancer: a double blind, parallel, randomized, controlled, feasibility trial. BMC Palliat Care, 2020; 19(1): 163.
23. LEWANDOWSKA K, et al. The role of melatonin and melatonin receptor agonist in the prevention of sleep disturbances and delirium in intensive care unit - a clinical review. Sleep Med, 2020; 69: 127-134.
24. MISTRALETTI G, et al. Melatonin reduces the need for sedation in ICU patients: a randomized controlled trial. Minerva Anestesiol. 2015; 81(12): 1298-310.
25. PEREIRA AS, et al. Metodologia da pesquisa científica. Santa Maria: Universidade Federal de Santa Maria, 2018; 119p.
26. PISANI MA, D'AMBROSIO C. Sleep and Delirium in Adults Who Are Critically Ill: A Contemporary Review. Chest, 2020; 157(4): 977-984.
27. RAMYA K, et al. Melatonin to prevent delirium in organophosphorus compound poisoning patients: a double-blind randomized control trial. Indian journal of critical care medicine, 2015; 19(13): S8-S9.
28. ROMERO N, et al. Evaluation of Delirium in Critically Ill Patients Prescribed Melatonin or Ramelteon. Ann Pharmacother, 2021; 55(11): 1347-1354.
29. SCHOLTENS RM, et al. Plasma melatonin levels in hip fracture patients with and without delirium: A confirmation study. Mech Ageing Dev, 2017; 167: 1-4.
30. SHA J, et al. Melatonin in the management of delirium in the elderly: double-blind randomized controlled pilot trial. Respirology, 2019; 24: 199.
31. SULTAN SS. Assessment of role of perioperative melatonin in prevention and treatment of postoperative delirium after hip arthroplasty under spinal anesthesia in the elderly. Saudi J Anaesth, 2010; 4(3): 169-73.