• Paul J T Rood, Marieke Zegers, Slooter Arjen J C AJC, Albert Beishuizen, Koen S Simons, van der Voort Peter H J PHJ, Meta C E van der Woude, Peter E Spronk, Johannes G van der Hoeven, Peter Pickkers, and Mark van den Boogaard.
• From the Department of Intensive Care Medicine, Radboud Institute Health Science, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands (P.J.T.R., M.Z., J.G.v.d.H., P.P., M.v.d.B.) the Department of Intensive Care Medicine and Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands (A.J.C.S.) the Department of Intensive Care Medicine, Medical Spectrum Twente, Enschede, The Netherlands (A.B.) the Department of Intensive Care Medicine, Jeroen Bosch Hospital Den-Bosch, The Netherlands (K.S.S.) the Department of Intensive Care Medicine, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands (P.H.J.v.d.V.) the Tilburg Institute for Academical Studies School for Business and Society, Tilburg University, Tilburg, The Netherlands (P.H.J.v.d.V.) the Department Intensive Care Medicine, Zuyderland Medical Center, Heerlen, The Netherlands (M.C.E.v.d.W.) the Department Intensive Care Medicine, Gelre Hospital, Apeldoorn, The Netherlands (P.E.S.).
• Anesthesiology. 2019 Aug 1; 131 (2): 328-335.

BackgroundDelirium incidence in intensive care unit patients is high and associated with impaired long-term outcomes. The use of prophylactic haloperidol did not improve short-term outcome among critically ill adults at high risk of delirium. This study evaluated the effects of prophylactic haloperidol use on long-term quality of life in this group of patients and explored which factors are associated with change in quality of life.MethodsA preplanned secondary analysis of long-term outcomes of the pRophylactic haloperidol usE for DeliriUm in iCu patients at high risk for dElirium (REDUCE) study was conducted. In this multicenter randomized clinical trial, nondelirious intensive care unit patients were assigned to prophylactic haloperidol (1 or 2 mg) or placebo (0.9% sodium chloride). In all groups, patients finally received study medication for median duration of 3 days [interquartile range, 2 to 6] until onset of delirium or until intensive care unit discharge. Long-term outcomes were assessed using the Short Form-12 questionnaire at intensive care unit admission (baseline) and after 1 and 6 months. Quality of life was summarized in the physical component summary and mental component summary scores. Differences between the haloperidol and placebo group and factors associated with changes in quality of life were analyzed.ResultsOf 1,789 study patients, 1,245 intensive care unit patients were approached, of which 887 (71%) responded. Long-term quality of life did not differ between the haloperidol and placebo group (physical component summary mean score of 39 ± 11 and 39 ± 11, respectively, and P = 0.350; and mental component summary score of 50 ± 10 and 51 ± 10, respectively, and P = 0.678). Age, medical and trauma admission, quality of life score at baseline, risk for delirium (PRE-DELIRIC) score, and the number of sedation-induced coma days were significantly associated with a decline in long-term quality of life.ConclusionsProphylactic haloperidol use does not affect long-term quality of life in critically ill patients at high risk for delirium. Several factors, including the modifiable factor number of sedation-induced coma days, are associated with decline in long-term outcomes.

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