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Intensive Care Medicine

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Open Access 01-03-2021 | Clonidine | Original

Haloperidol, clonidine and resolution of delirium in critically ill patients: a prospective cohort study

Authors: Lisa Smit, Sandra M. A. Dijkstra-Kersten, Irene J. Zaal, Mathieu van der Jagt, Arjen J. C. Slooter

Published in: Intensive Care Medicine | Issue 3/2021

Abstract

Purpose

Haloperidol and clonidine are commonly used to treat agitation in delirious intensive care unit (ICU) patients, but it is unclear whether these agents may shorten the duration of delirium. The objective of this study was to determine whether haloperidol, clonidine, or their combined administration to delirious ICU patients results in delirium resolution.

Methods

This was a cohort study on a mixed ICU, excluding patients with a primary neurological disorder. The main outcome was the probability of delirium resolution, using propensity score matching and Markov multinomial logistic regression models for daily transitions. Secondary outcomes were delirium duration, number of delirium days, ventilation days, length of stay in the ICU and hospital, and ICU mortality.

Results

A total of 3614 patients were included (1165 delirious [32%]; 2449 non-delirious [68%]). Delirium occurred on 4708 (18.9%) of 24,906 days. The probability of delirium resolution was lower in delirious patients who received haloperidol (OR 0.47, 95% CI 0.39–0.57), clonidine (OR 0.78, 95% CI 0.63–0.97), or both (OR 0.45, 95% CI 0.36–0.56) compared to untreated delirious patients. Delirious patients who received haloperidol, clonidine, or both had generally longer delirium duration, more delirium and ventilation days, and spent more time in the ICU and in hospital than untreated delirious patients. These agents had no effect on ICU mortality.

Conclusion

Haloperidol and clonidine use in delirious ICU patients may be associated with reduced probability of delirium resolution. This finding, however, merits further investigation given inherent limitations of this observational analysis.

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Title: Haloperidol, clonidine and resolution of delirium in critically ill patients: a prospective cohort study
Authors: Lisa Smit
Sandra M. A. Dijkstra-Kersten
Irene J. Zaal
Mathieu van der Jagt
Arjen J. C. Slooter
Publication date: 01-03-2021
Publisher: Springer Berlin Heidelberg
Keywords: Clonidine
Care
Haloperidol
Published in: Intensive Care Medicine / Issue 3/2021
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-021-06355-9

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Haloperidol, clonidine and resolution of delirium in critically ill patients: a prospective cohort study

Abstract

Purpose

Methods

Results

Conclusion

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