Author’s reply to the comments by de Rooij and de Jonge

Excerpt

Sir: We thank Drs. Sophia de Rooij and Evert de Jonge for emphasizing the importance that delirium has on the critically ill patient’s outcome. Removing offending agents, treating suspected causal medical conditions, and reducing the impact of environmental factors are the recommended, if not evidence-based, first steps to managing ICU delirium [1]. Associated psychiatric symptoms and/or behavioral disturbances often require pharmacological intervention [1]. Haloperidol, especially the intravenous form, has been proposed as the treatment of choice for the symptomatic management of delirium in the intensive care setting [2, 3]. However, the use of intravenous haloperidol in ICU delirium is based primarily on historical rather than scientific grounds; this indication is not approved by the United States Food and Drug Administration. …