Haloperidol for the Management of Delirium in Adult ICU Patients

Haloperidol for the Management of Delirium in Adult ICU Patients

Among critically ill patients, haloperidol administration compared with placebo does not significantly affect short-term mortality, incidence of delirium, ICU length of stay, or delirium or coma-free days. Additionally, there... read more

Taming the Ketamine Tiger

Taming the Ketamine Tiger

THOSE who anesthetize patients with ketamine (originally given the clinical investigation number CI-581) realize it is a unique pharmacological agent. Ever since its introduction into human clinical anesthesia, ketamine has... read more

A Familiar Story: Delirium in the Acute Care Setting

A Familiar Story: Delirium in the Acute Care Setting

A few years ago, I received report that a patient was ready to be weaned from the ventilator. He had no respiratory need for mechanical ventilation, and every time the medical team attempted to wean sedation to extubate,... read more

Antimicrobial Exposure and the Risk of Delirium in Critically Ill Patients

Antimicrobial Exposure and the Risk of Delirium in Critically Ill Patients

First-, second-, and third-generation cephalosporins doubled the odds of delirium after baseline co-morbidities, ICU type, the course of critical care, and other competing antimicrobial and psychotropic medication risks were... read more

Caring for Critically Ill Patients with the ABCDEF Bundle

Caring for Critically Ill Patients with the ABCDEF Bundle

ABCDEF bundle performance showed significant and clinically meaningful improvements in outcomes including survival, mechanical ventilation use, coma, delirium, restraint-free care, ICU readmissions, and post-ICU discharge... read more

Remodeling ICU Care

Remodeling ICU Care

A new study finding that two antipsychotics were no more effective than placebo for delirium in critical illness spurs discussion about alternative methods for managing that care. Neither haloperidol nor ziprasidone — both... read more

The Effectiveness of Non-Pharmacological Interventions in Reducing the Incidence and Duration of Delirium in Critically Ill Patients

The Effectiveness of Non-Pharmacological Interventions in Reducing the Incidence and Duration of Delirium in Critically Ill Patients

Current evidence does not support the use of non-pharmacological interventions in reducing incidence and duration of delirium in critically ill patients. Future research should consider well-designed and well-described multicomponent... read more

Delirium in Critical Illness: Haloperidol vs Ziprasidone?

Delirium in Critical Illness: Haloperidol vs Ziprasidone?

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,... read more

Improving Hospital Survival and Reducing Brain Dysfunction at Seven California Community Hospitals

Improving Hospital Survival and Reducing Brain Dysfunction at Seven California Community Hospitals

The evidence-based ABCDEF bundle was successfully implemented in seven community hospital ICUs using an interprofessional team model to operationalize the Pain, Agitation, and Delirium guidelines. Higher bundle compliance... read more

No more antipsychotics for delirium? Not so fast!

No more antipsychotics for delirium? Not so fast!

Recently the MINDS-USA trial evaluated the use of haloperidol or ziprasidone for delirium in critical illness. Before jumping into the results of this study, it will help to establish a couple of foundational principles.... read more

Early Mobilization in the PICU

Early Mobilization in the PICU

Mobilization of critically ill children, many with central lines, endotracheal tubes, and other life-saving devices, is associated with potential risks and complications. Hence, concerns about safety often guide staff perceptions... read more

Prevalence for Delirium in Stroke Patients

Prevalence for Delirium in Stroke Patients

These results underline the importance of delirium screening in stroke patients specifically during the night. Since even short delirious episodes are associated with more complications and increased disability, future studies... read more

Dopamine Antagonists in ICU Delirium

Dopamine Antagonists in ICU Delirium

Perhaps the most vexing problem in a patient in an intensive care unit (ICU) is an unexpected change in mental status. Historically, "acute encephalopathy" was the term used to encompass such alterations, but "delirium" is... read more

Haloperidol and Ziprasidone for Treatment of Delirium in Critical Illness

Haloperidol and Ziprasidone for Treatment of Delirium in Critical Illness

The use of haloperidol or ziprasidone, as compared with placebo, in patients with acute respiratory failure or shock and hypoactive or hyperactive delirium in the ICU did not significantly alter the duration of delirium.... read more

Antipsychotic Drugs Don’t Ease ICU Delirium Or Dementia

Antipsychotic Drugs Don’t Ease ICU Delirium Or Dementia

Powerful drugs that have been used for decades to treat delirium are ineffective for that purpose, according to a study published online Monday in the New England Journal of Medicine. Antipsychotic medications, such as haloperidol... read more

When ICU Delirium Leads To Symptoms Of Dementia After Discharge

Doctors have gradually come to realize that people who survive a serious brush with death in the intensive care unit are likely to develop potentially serious problems with their memory and thinking processes. This dementia,... read more

Stopping ICU delirium by getting patients moving

Stopping ICU delirium by getting patients moving

Doctor says the treatment plan makes a 'massive difference' to those in critical care. Any hospital stay can be traumatic. But 30 percent of patients in intensive care units experience ICU delirium. The rate for... read more