Delirium in Critical Illness: Haloperidol vs Ziprasidone?

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Delirium is defined as an acute disorder of consciousness which can occur in up to 80% of mechanically ventilated ICU patients. This acute cognitive dysfunction is associated with prolonged hospital stay, increased mortality, longer periods of mechanical ventilation and long-term cognitive impairment compared to patients without delirium. Haloperidol, remains one of the most commonly used typical antipsychotics used to treat delirium internationally and within the United States. The Society of Critical Care Medicine’s recent guidelines do not suggest the use of Haloperidol in the prevention or treatment of delirium and understandably so as two randomized trials showed no reduction in duration of ICU delirium.

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