Table 2 Nicotine replacement therapy, agitation, delirium, and associated risk factors

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

RASS^a

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 mcg^a

NRT = 50 (0–874.9)

No NRT = 0 (0–472)

P < 0.001

Lorazepam equivalence mg^a

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 days^b

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