Atypical Antipsychotics for the Treatment of ICU Delirium

Journal of Intensive Care Medicine - Tập 27 Số 6 - Trang 354-361 - 2012
Neil A. Gilchrist1,2, Ifeoma Asoh1, Bruce Greenberg3
1Department of Pharmacy, UMass Memorial Medical Center, Worcester, MA, USA
2Massachusetts College of Pharmacy and Health Sciences, Worcester, MA, USA
3Department of Pulmonary, Allergy, and Critical Care Medicine, UMass Memorial Medical Center, Worcester, MA, USA

Tóm tắt

Delirium is commonly described in critically ill patients as 1 factor contributing to increased length of intensive care unit and hospital stay, secondary complications, and increased mortality. Initial screening tools for delirium in hospitalized patients are generally easy to use; however, many centers have struggled with implementing these tools in a consistent and systematic manner. Haloperidol has traditionally been prescribed as the primary agent of choice for the treatment of delirium in critically ill patients. Clinicians have been challenged to consider alternative agents due to adverse effects such as extrapyramidal symptoms, QTc prolongation, and possible torsades de pointes with haloperidol use. The atypical antipsychotics are attractive alternatives to haloperidol with improved safety profiles but are flawed by limited data to support dosing and efficacy in this patient population. Future studies that provide large, prospective, double-blinded, placebo-controlled data to support the implementation of these agents as standard therapy over haloperidol are needed.

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Journal of Intensive Care Medicine

Tập 27 Số 6

354-361

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