Date of Award

8-7-2020

Document Type

Open Access Thesis

Degree Name

MS in Physician Assistant Studies (PA)

Department

Physician Assistant Studies

First Advisor

Amanda Perkins, PharmD

Abstract

Background: Acute delirium is a common complication among critically ill patients. Besides the manifestation of distressing symptoms, delirium can result in negative patient outcomes. Several studies show that antipsychotics such as haloperidol are one of the most commonly used interventions for delirium despite large variability and lower quality of evidence available to advocate for their use.

Methods: A literature review was conducted to investigate current evidence on the use of antipsychotic agents for preventing and treating delirium in the intensive care unit.

Discussion: There is conflicting data concerning the prophylaxis and treatment of delirium in critically ill patients. For prophylaxis with antipsychotics, some studies have shown a decrease in delirium incidence in post-operative patients with less effect on general ICU populations. For treatment with antipsychotics, smaller low-powered studies have shown a decrease in delirium duration while other studies do not show any benefit. High heterogeneity between studies due to variable study design makes the quality of evidence low. Minimal conclusions can be drawn from available literature, making it difficult to provide concrete clinical recommendations.

Conclusion: Given the low quality of evidence, the effectiveness of antipsychotics for ICU delirium remains uncertain. Antipsychotics should not be implemented for routine use, but can be considered to treat severe, acute delirium symptoms. Future research is needed to better establish the benefits and risks associated with antipsychotics and delirium in the ICU.

Identifier

Sc 11.PAS.2020.Brateng.E

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