This meta-analysis fails to support that bundle interventions are effective in reducing ICU delirium prevalence and duration, but supports that bundle interventions are effective in reducing the proportion of patient-days with coma, hospital length of stay, and 28-day mortality.

Larger randomized clinical trials are needed to evaluate the impact of bundle interventions on ICU delirium and other clinical outcomes.

Eleven studies with a total of 26,384 adult participants were included in the meta-analysis. Five studies (three randomized clinical trials and two cohort studies) involving 18,638 patients demonstrated that ICU delirium prevalence was not reduced.

Meta-analysis showed that the use of bundle interventions was not associated with shortening the duration of ICU delirium, increasing ventilator-free days, decreasing mechanical ventilation days, ICU length of stay, and inhospital mortality.

However, bundle interventions are effective in reducing the proportion of patient-days experiencing coma, hospital length of stay, and 28-day mortality by 18%.

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