Clinical Pharmacy Research
Drug Safety

Mount Sinai Hospital
600 University Avenue, Rm 18-377 Department of Pharmacy
Toronto ON M5G 1X5

Area of Research

Lisa Burry’s research focuses on symptom management in the intensive care unit (ICU), in particular preventing or treating delirium in the ICU through approaches such as optimizing sedation.

Research Challenge

More than half of patients in the ICU experience delirium, which can negatively affect patient health in the short and long term. In the short term, patients with delirium end up staying in the ICU longer on a breathing machine, increasing their risk of negative health effects and even death. In the long term, delirium may leave patients with cognitive impairments that lower the likelihood that they will return home from hospital care. Patients in the ICU often experience pain, anxiety and sleep deprivation and require pain control or sedation, all of which may contribute to the severity or likelihood of delirium.

Proposed Solution

Lisa Burry works to determine the factors that contribute to or prevent delirium in critically ill patients and looks for possible strategies to optimize sedation and delirium management in the ICU. Her research, which includes randomized controlled trials, observational studies and literature reviews, examines factors that may increase risk of delirium (e.g., the use of certain medications such as benzodiazepines) and those that may decrease the risk (e.g., proper sleep-wake cycles or melatonin use). She conducts systematic literature reviews that identify the most effective strategies to prevent or treat delirium in the ICU, which guides patient care and informs future research, and performs surveys of ICU staff and patient preference, which will support the development of clinical trials that are informed by patient and family preferences.

Impact To Date

Burry’s research is helping to address sedation and delirium in the ICU and improve patient care. In a recent study, Burry observed that 90% of patients in the ICU are exposed to opioids and sedatives, especially in the form on continuous infusions which are known to accumulate and prolong time on a breathing machine. In another large study, her group showed that two benzodiazepines and drugs with anticholinergic activity are independently associated with delirium in ICU patients. Knowing which medications increase the risk of delirium and how best to administer these drugs allows clinicians to strategize treatments that minimize the use of these drugs. Burry has also completed large systematic reviews on delirium prevention, delirium treatment, and sedation in mechanically ventilated patients that will be incorporated into the Society of Critical Care Medicine’s newest guidelines for prevention and treatment of delirium.



Keywords: critical care, intensive care, drug safety, delirium, sedation