Sedation minimization and early mobility to prevent intensive care unit delirium

Authors

• Alana M. Kugelard, University of LynchburgFollow

Specialty

Critical Care

Abstract

The purpose of this paper is to synthesize current evidence on sedation minimization, early mobility, and multicomponent care bundles for the prevention of intensive care unit (ICU) delirium in critically ill adult patients. ICU delirium is a common and serious complication associated with increased mortality, prolonged mechanical ventilation, extended ICU and hospital length of stay, and long-term cognitive impairment, making it a significant safety and quality-of-care concern. A literature review was conducted using PubMed and the Cochrane Library, with search terms including “ICU delirium,” “sedation minimization,” “light sedation,” “early mobilization,” and “ABCDEF bundle.” Filters included adult populations, peer-reviewed studies, randomized controlled trials, prospective cohort studies, and clinical guidelines published in the past ten years, with inclusion based on relevance to delirium prevention. Studies consistently demonstrated that lighter sedation was associated with reduced delirium incidence compared to deep sedation, especially in mechanically ventilated individuals. Pharmacologic choice also demonstrated a significant role in delirium outcomes, with dexmedetomidine showing more delirium-sparing effects compared to agents such as propofol. Early mobility interventions including physical therapy, occupational therapy, and progressive mobilization during critical illness are also associated with improved functional recovery and reduced delirium incidence. Structured bundles such as the ABCDEF framework that implement sedation minimization, early mobility, delirium monitoring, spontaneous awakening and breathing trials, and family engagement together demonstrated the most consistent and effective benefits. These findings are clinically significant because they support evidence-based practices that improve outcomes, reduce complications, and enhance recovery of critically ill patients. Future research should focus on strategies to implement these frameworks and overcome barriers to allow for consistent adoption of these interventions across all ICU settings.

Recommended Citation

Kugelard AM. Sedation minimization and early mobility to prevent intensive care unit delirium. University of Lynchburg Doctoral Project Assignment Repository. 2026; 8(2).