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学科主题: 临床医学
题名:
Haloperidol prophylaxis decreases delirium incidence in elderly patients after noncardiac surgery: A randomized controlled trial
作者: Wang, Wei1; Li, Hong-Liang3; Wang, Dong-Xin1; Zhu, Xi3; Li, Shuang-Ling1; Yao, Gai-Qi3; Chen, Kai-Sheng1; Gu, Xiu-E1; Zhu, Sai-Nan2
关键词: aged ; control ; delirium ; haloperidol ; intensive care units ; postoperative complications ; prevention
刊名: CRITICAL CARE MEDICINE
发表日期: 2012-03-01
DOI: 10.1097/CCM.0b013e3182376e4f
卷: 40, 期:3, 页:731-739
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Critical Care Medicine
研究领域[WOS]: General & Internal Medicine
关键词[WOS]: INTENSIVE-CARE-UNIT ; CRITICALLY-ILL PATIENTS ; MECHANICALLY VENTILATED PATIENTS ; STRIATAL ACETYLCHOLINE-RELEASE ; CONFUSION ASSESSMENT METHOD ; AGITATION-SEDATION SCALE ; POSTOPERATIVE DELIRIUM ; CARDIAC-SURGERY ; RISK-FACTORS ; SURGICAL-PATIENT
英文摘要:

Objectives: To evaluate the efficacy and safety of short-term low-dose intravenous haloperidol for delirium prevention in critically ill elderly patients after noncardiac surgery.

Design: Prospective, randomized, double-blind, and placebo-controlled trial in two centers.

Setting: Intensive care units of two large tertiary teaching hospitals.

Patients: Four hundred fifty-seven patients 65 yrs or older who were admitted to the intensive care unit after noncardiac surgery.

Intervention: Haloperidol (0.5 mg intravenous bolus injection followed by continuous infusion at a rate of 0.1 mg/h for 12 hrs; n = 229) or placebo (n = 228) was randomly administered from intensive care unit admission.

Measures: The primary end point was the incidence of delirium within the first 7 days after surgery. Secondary end points included time to onset of delirium, number of delirium-free days, length of intensive care unit stay, all-cause 28-day mortality, and adverse events. Delirium was assessed using the confusion assessment method for the intensive care unit.

Results: The incidence of delirium during the first 7 days after surgery was 15.3% (35/229) in the haloperidol group and 23.2% (53/228) in the control group (p = .031). The mean time to onset of delirium and the mean number of delirium-free days were significantly longer (6.2 days [95% confidence interval 5.9-6.4] vs. 5.7 days [95% confidence interval 5.4-6.0]; p = .021; and 6.8 +/- 0.5 days vs. 6.7 +/- 0.8 days; p = .027, respectively), whereas the median length of intensive care unit stay was significantly shorter (21.3 hrs [95% confidence interval 20.3-22.2] vs. 23.0 hrs [95% confidence interval 20.9 25.1]; p = .024) in the haloperidol group than in the control group. There was no significant difference with regard to all-cause 28-day mortality between the two groups (0.9% [2/229] vs. 2.6% [6/228]; p = .175). No drug-related side effects were documented.

Conclusions: For elderly patients admitted to intensive care unit after noncardiac surgery, short-term prophylactic administration of low-dose intravenous haloperidol significantly decreased the incidence of postoperative delirium. The therapy was well-tolerated. (Crit Care Med 2012; 40:731-739)

语种: 英语
WOS记录号: WOS:000300532800003
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/68272
Appears in Collections:北京大学第一临床医学院_期刊论文

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作者单位: 1.Peking Univ, Hosp 1, Dept Anesthesiol & Surg Intens Care, Beijing 100871, Peoples R China
2.Peking Univ, Hosp 1, Dept Biostat, Beijing 100871, Peoples R China
3.Peking Univ, Hosp 3, Dept Crit Care Med, Beijing 100871, Peoples R China

Recommended Citation:
Wang, Wei,Li, Hong-Liang,Wang, Dong-Xin,et al. Haloperidol prophylaxis decreases delirium incidence in elderly patients after noncardiac surgery: A randomized controlled trial[J]. CRITICAL CARE MEDICINE,2012,40(3):731-739.
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