title: Assessing the role of hydration in delirium at the end of life.
abstract: OBJECTIVE
  Delirium is the most frequent neuropsychiatric disorder that affects the advanced cancer population who are receiving palliative care. There is limited evidence and much debate about the role of hydration in delirium management at the end of life. The purpose of this article is to review the literature on delirium management with regards to pharmacological management and hydration.
  
  
  RESULTS
  Pharmacological management is the first line of treatment for delirium, whereby antipsychotics are the medication of choice. However, they have not been approved by the United States Food and Drug Administration for delirium management as there is insufficient evidence supporting their use. Hydration is a believed to be a key component of delirium reversibility; yet there are conflicting results on its efficacy as an intervention for delirium management. As there are few studies of good methodological quality on the topic and large variations in practice, the effectiveness of hydration as an alternative management option for delirium is unclear.
  
  
  CONCLUSIONS
  More work is required to assess the role of hydration in delirium at the end of life. Given the lack of evidence-based research on hydration, more randomized clinical trials are needed to elucidate the effects of hydration as a delirium intervention.
authors.affiliation: Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montreal, Quebec, Canada. chrissi.galanakis@mail.mcgill.ca
authors.forename: Chrissi
authors.initials: C
authors.lastname: Galanakis
authors.forename: Nancy E
authors.initials: NE
authors.lastname: Mayo
authors.forename: Bruno
authors.initials: B
authors.lastname: Gagnon
mesh_terms: D000701:Analgesics, Opioid / Q000009:adverse effects* / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000627:therapeutic use; D003681:Dehydration / Q000150:complications / Q000209:etiology / Q000628:therapy; D003693:Delirium / Q000188:drug therapy / Q000209:etiology / Q000628:therapy*; D005440:Fluid Therapy / Q000009:adverse effects / Q000379:methods / Q000592:standards*; D006801:Humans; D009369:Neoplasms / Q000150:complications* / Q000188:drug therapy / Q000628:therapy; D010166:Palliative Care / Q000379:methods*; D019452:Terminally Ill
chemical_list: D000701:Analgesics, Opioid; D014150:Antipsychotic Agents