Antipsychotic Treatment of Delirium in Critically Ill Children: A Retrospective Matched Cohort Study
| Autor: | Shari Simone, Jamie Tumulty, Sarah Edwards, Allison B Lardieri, Ana Lia Graciano, Omayma A. Kishk |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Pediatrics
medicine.medical_specialty Risperidone business.industry Critically ill Clinical Investigations 030208 emergency & critical care medicine Antipsychotic treatment behavioral disciplines and activities nervous system diseases Pharmacological treatment 03 medical and health sciences 0302 clinical medicine Matched cohort mental disorders Pediatrics Perinatology and Child Health Haloperidol Medicine Quetiapine Delirium Pharmacology (medical) 030212 general & internal medicine medicine.symptom business medicine.drug |
| Zdroj: | The Journal of Pediatric Pharmacology and Therapeutics. 24:204-213 |
| ISSN: | 1551-6776 |
| DOI: | 10.5863/1551-6776-24.3.204 |
| Popis: | OBJECTIVE To describe the use of pharmacologic treatment in critically ill children treated according to a delirium protocol and compare those treated with antipsychotics to those treated non-pharmacologically. METHODS The study included a retrospective matched cohort describing patients who were pharmacologically treated for delirium compared to those with delirium but not treated in a PICU from December 2013 to September 2015, using a delirium management protocol. Patients were matched by age, sex, diagnosis, mechanical ventilation (MV), and presence of delirium. RESULTS Of 1875 patients screened, 188 (10.03%) were positive for delirium. Of those, 15 patients (8%) were treated with an antipsychotic for delirium. Patients with delirium treated with antipsychotics were younger, had more delirium days (6 vs. 3, p=0.022), longer MV days (14 vs. 7, p=0.017), and longer PICU length of stay (34 vs. 16 days, p=0.029) than in the untreated group. Haloperidol, risperidone, and quetiapine were used in 9, 6, and 2 patients, respectively. Two patients were treated with multiple antipsychotics. Antipsychotic treatment was initiated on day 2 of delirium for 8 of 15 patients (53.3%). Ten patients in the treatment group had improved delirium scores by day 2 of treatment. No significant differences in sedation exposure between groups. No significant adverse effects were reported. CONCLUSIONS No significant adverse events seen in this small cohort of critically ill pediatric patients with delirium treated with antipsychotic therapy. Patients with early-onset delirium refractory to non-pharmacologic treatment may have a more effective response to antipsychotic therapy than patients with late-onset refractory delirium. |
| Databáze: | OpenAIRE |
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