The DOI matches its Crossref record; 34 of the 34 references it cites were found in a registry or an index.
Dexmedetomidine vs. haloperidol in delirious, agitated, intubated patients: a randomised open-label trial
Open accessAbstract
Introduction: Agitated delirium is common in patients undergoing mechanical ventilation, and is often treated with haloperidol despite concerns about safety and efficacy. Use of conventional sedatives to control agitation can preclude extubation. Dexmedetomidine, a novel sedative and anxiolytic agent, may have particular utility in these patients. We sought to compare the efficacy of haloperidol and dexmedetomidine in facilitating extubation. Methods: We conducted a randomised, open-label, parallel-groups pilot trial in the medical and surgical intensive care unit of a university hospital. Twenty patients undergoing mechanical ventilation in whom extubation was not possible solely because of agitated delirium were randomised to receive an infusion of either haloperidol 0.5 to 2 mg/hour or dexmedetomidine 0.2 to 0.7 μg/kg/hr, with or without loading doses of 2.5 mg haloperidol or 1 μg/kg dexmedetomidine, according to clinician preference. Results: Dexmedetomidine significantly shortened median time to extubation from 42.5 (IQR 23.2 to 117.8) to 19.9 (IQR 7.3 to 24) hours (P = 0.016). Dexmedetomidine significantly decreased ICU length of stay, from 6.5 (IQR 4 to 9) to 1.5 (IQR 1 to 3) days (P = 0.004) after study drug commencement. Of patients who required ongoing propofol sedation, the proportion of time propofol was required was halved in those who received dexmedetomidine (79.5% (95% CI 61.8 to 97.2%) vs. 41.2% (95% CI 0 to 88.1%) of the time intubated; P = 0.05). No patients were reintubated; three receiving haloperidol could not be successfully extubated and underwent tracheostomy. One patient prematurely discontinued haloperidol due to QTc interval prolongation. Conclusions: In this preliminary pilot study, we found dexmedetomidine a promising agent for the treatment of ICU-associated delirious agitation, and we suggest this warrants further testing in a definitive double-blind multi-centre trial. Trial registration: Clinicaltrials.gov NCT00505804
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The Revised CONSORT Statement for Reporting Randomized Trials: Explanation and Elaboration
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Delirium as a Predictor of Mortality in Mechanically Ventilated Patients in the Intensive Care Unit
Ely, E. W. (2004) · JAMA · doi:10.1001/jama.291.14.1753 · Cited by 3,073
Jacobi, J., Fraser, G. L., Coursin, D. B., Riker, R. R., Fontaine, D., Wittbrodt, E. T., Chalfin, D. B., Masica, M. F., Bjerke, H. S., Coplin, W. M., et al. (2002) · Critical Care Medicine · doi:10.1097/00003246-200201000-00020 · Cited by 1,895
Riker, R. R. (2009) · JAMA · doi:10.1001/jama.2009.56 · Cited by 1,672
Intensive Care Delirium Screening Checklist: evaluation of a new screening tool
Bergeron, N., Dubois, M.-J., Dumont, M., Dial, S., & Skrobik, Y. (2001) · Intensive Care Medicine · doi:10.1007/s001340100909 · Cited by 1,487 · cited 1×
“Data collected included study drug rate, use of other sedatives, RASS score, Intensive Care Delirium Screening Checklist (ICDSC) score [ 16 ], requirement for physical restraint, mean arterial pressure, requirement and rate of vasopressors and inotropes, and the presence of arrhythmias or any other adverse event.”
Pandharipande, P. P., Pun, B. T., Herr, D. L., Maze, M., Girard, T. D., Miller, R. R., Shintani, A. K., Thompson, J. L., Jackson, J. C., Deppen, S. A., et al. (2007) · JAMA · doi:10.1001/jama.298.22.2644 · Cited by 1,451
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Prospective evaluation of the Sedation-Agitation Scale for adult critically ill patients
Riker, R. R., Picard, J. T., & Fraser, G. L. (1999) · Critical Care Medicine · doi:10.1097/00003246-199907000-00022 · Cited by 961
Cited by
Early Intensive Care Sedation Predicts Long-Term Mortality in Ventilated Critically Ill Patients
Shehabi, Y., Bellomo, R., Reade, M. C., Bailey, M., Bass, F., Howe, B., McArthur, C., Seppelt, I. M., Webb, S., Weisbrodt, L., et al. (2012) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.201203-0522oc · Cited by 559
Self-citationvan den Boogaard, M., Schoonhoven, L., Evers, A. W. M., van der Hoeven, J. G., van Achterberg, T., & Pickkers, P. (2012) · Critical Care Medicine · doi:10.1097/ccm.0b013e31822e9fc9 · Cited by 361
Maldonado, J. R. (2017) · Critical Care Clinics · doi:10.1016/j.ccc.2017.03.013 · Cited by 325
Delirium in the ICU: an overview
Cavallazzi, R., Saad, M., & Marik, P. E. (2012) · Annals of Intensive Care · doi:10.1186/2110-5820-2-49 · Cited by 275
Antipsychotics for treatment of delirium in hospitalised non-ICU patients
Burry, L., Mehta, S., Perreault, M. M., Luxenberg, J. S., Siddiqi, N., Hutton, B., Fergusson, D. A., Bell, C., & Rose, L. (2018) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd005594.pub3 · Cited by 237
Metadata
- Authors
- Reade, M. C., O'Sullivan, K., Bates, S., Goldsmith, D., Ainslie, W. R., & Bellomo, R.
- Venue
- Critical Care
- Published
- 2009-05-19
- Volume
- 13
- Issue
- 3
- Pages
- R75-R75
- ISSN
- 1364-8535 (ISSN-L)
- OpenAlex
- W2147364251
- Cited by
- 263
- References
- 34
- FWCI
- 23.12
- Type
- journal article
- Language
- en
- Open access
- gold
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- Reade, M. C., O'Sullivan, K., Bates, S., Goldsmith, D., Ainslie, W. R., & Bellomo, R. (2009). Dexmedetomidine vs. haloperidol in delirious, agitated, intubated patients: a randomised open-label trial. Critical Care. https://doi.org/10.1186/cc7890
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