Restrição física como fator associado à ocorrência de delirium em pacientes críticos: revisão integrativa

OBJECTIVE: To analyze scientific production on the physical restraint as a factor associated with the occurrence of delirium in critically ill patients. METHOD: Integrative review of articles published between 2009 and 2021. Data was collected from the PUBMED, CINAHL, LILACS, Web of Science and PsychINFO databases. Articles were included that were available in full text and in which delirium was monitored using validated instruments. RESULTS: Eight articles met the eligibility criteria. All studies show that there is a relationship between the use of physical restraint and the development of delirium. The frequency of delirium in patients using physical restraint ranged from 38% to 79.6%, with odds ratios ranging from 4.16 (95% CI 2.37-7.29) to 33.84 (95% CI 11.19 - 102.36). Two studies evaluated the motor spectrums of delirium, one of which found that hyperactive delirium was more common in 36.4% of cases, while the other found that hypoactive delirium was more common in 50% of cases. One study showed that the location of the restriction in the wrists was the most used (95% of patients). The included studies did not evaluate the duration of use, number and location of physical restraints and their association with the occurrence, severity, subtypes and duration of delirium. CONCLUSION: The results suggest that physical restraint is a factor associated with the occurrence of delirium in critically ill patients.