Dexmedetomidine vs. haloperidol in delirious, agitated, intubated patients: a randomised open-label trial

• DOI: 10.1186/cc7890
• Publication Date: 2009-05-19T18:49:19Z
• Authors: Michael C Reade; Kim O'Sullivan; Samantha Bates; Donna Goldsmith; William RSTJ Ainslie; Rinaldo Bellomo
• Keywords: Dexmedetomidine; Open label; Psychomotor agitation

Abstract Introduction Agitated delirium is common in patients undergoing mechanical ventilation, and often treated with haloperidol despite concerns about safety efficacy. Use of conventional sedatives to control agitation can preclude extubation. Dexmedetomidine, a novel sedative anxiolytic agent, may have particular utility these patients. We sought compare the efficacy dexmedetomidine facilitating Methods conducted randomised, open-label, parallel-groups pilot trial medical surgical intensive care unit university hospital. Twenty ventilation whom extubation was not possible solely because agitated were randomised receive an infusion either 0.5 2 mg/hour or 0.2 0.7 μg/kg/hr, without loading doses 2.5 mg 1 μg/kg dexmedetomidine, according clinician preference. Results Dexmedetomidine significantly shortened median time from 42.5 (IQR 23.2 117.8) 19.9 7.3 24) hours ( P = 0.016). decreased ICU length stay, 6.5 4 9) 1.5 3) days 0.004) after study drug commencement. Of who required ongoing propofol sedation, proportion halved those received (79.5% (95% CI 61.8 97.2%) vs. 41.2% 0 88.1%) intubated; 0.05). No reintubated; three receiving could be successfully extubated underwent tracheostomy. One patient prematurely discontinued due QTc interval prolongation. Conclusions In this preliminary study, we found promising agent for treatment ICU-associated delirious agitation, suggest warrants further testing definitive double-blind multi-centre trial. Trial registration Clinicaltrials.gov NCT00505804