Abstract: Objective To systematically review the guidelines on non-pharmacological management of delirium in ICU patients. Methods The guideline networks, association websites and databases were electronically searched to collect guidelines on non-pharmacological management of delirium in ICU patients from the inception to 30 September 2019. Two reviewers worked independently to screen literature, extract data, and evaluate the included guidelines according to the standard quality appraisal tool AGREE II, and then summarized and compared the recommendations related to non-pharmacological management of delirium in ICU patients. Results Ten guidelines were included and nine of them were foreign ones. The average score of each AGREE II domain was 83% for scope and purpose, 55% for stakeholder involvement, 61% for rigor of development, 82% for clarity of presentation, 65% for applicability, and 38% for editorial independence. Four guidelines rated as Grade A and the remaining six as Grade B. Five aspects were involved in recommendations, including identification of risk factors and risk prediction; assessment and diagnosis; non-pharmacological prevention; non-pharmacological treatment and (Consultation) Referral and follow-up. Conclusion The overall quality of included guidelines is in a moderate to high level. More efforts are needed to improve the stakeholder involvement, rigor of development, applicability and independence domain of guidelines. At present, the development of guidelines on non-pharmacological management of delirium in ICU patients in China is still at initial stage. It is suggested to formulate localized guidelines that are suitable for China as soon as possible.

Key words: ICU, delirium, non-pharmacological management, guideline, systematic review