Haloperidol for the Treatment of Delirium in ICU Patients

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Haloperidol for the Treatment of Delirium in ICU Patients. / Andersen-Ranberg, Nina C.; Poulsen, Lone M.; Perner, Anders; Wetterslev, Jørn; Estrup, Stine; Haestbacka, Johanna; Morgan, Matt; Citerio, Giuseppe; Caballero, Jesus; Lange, Theis; Kjaer, Maj-Brit N.; Ebdrup, Bjorn H.; Engstrom, Janus; Olsen, Markus H.; Oxenboll Collet, Marie; Mortensen, Camilla B.; Weber, Sven-Olaf; Andreasen, A. Sofie; Bestle, Morten H.; Uslu, Buelent; Scharling Pedersen, Helle; Gramstrup Nielsen, Louise; Toft Boesen, Hans C.; Jensen, Jacob V.; Nebrich, Lars; La Cour, Kirstine; Laigaard, Jens; Haurum, Cecilie; Olesen, Marie W.; Overgaard-Steensen, Christian; Westergaard, Bo; Brand, Bjorn A.; Kingo Vesterlund, Gitte; Thornberg Kyhnauv, Pernille; Mikkelsen, Vibe S.; Hyttel-Sorensen, Simon; de Haas, Inge; Aagaard, Soren R.; Nielsen, Line O.; Eriksen, Anne S.; Rasmussen, Bodil S.; Brix, Helene; Hildebrandt, Thomas; Schonemann-Lund, Martin; Fjeldsoe-Nielsen, Hans; Kuivalainen, Anna-Maria; Mathiesen, Ole; AID ICU Trial Grp.

I: New England Journal of Medicine, Bind 387, Nr. 20, 2022, s. 2425-2435.

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt

Harvard

Andersen-Ranberg, NC, Poulsen, LM, Perner, A, Wetterslev, J, Estrup, S, Haestbacka, J, Morgan, M, Citerio, G, Caballero, J, Lange, T, Kjaer, M-BN, Ebdrup, BH, Engstrom, J, Olsen, MH, Oxenboll Collet, M, Mortensen, CB, Weber, S-O, Andreasen, AS, Bestle, MH, Uslu, B, Scharling Pedersen, H, Gramstrup Nielsen, L, Toft Boesen, HC, Jensen, JV, Nebrich, L, La Cour, K, Laigaard, J, Haurum, C, Olesen, MW, Overgaard-Steensen, C, Westergaard, B, Brand, BA, Kingo Vesterlund, G, Thornberg Kyhnauv, P, Mikkelsen, VS, Hyttel-Sorensen, S, de Haas, I, Aagaard, SR, Nielsen, LO, Eriksen, AS, Rasmussen, BS, Brix, H, Hildebrandt, T, Schonemann-Lund, M, Fjeldsoe-Nielsen, H, Kuivalainen, A-M, Mathiesen, O & AID ICU Trial Grp 2022, 'Haloperidol for the Treatment of Delirium in ICU Patients', New England Journal of Medicine, bind 387, nr. 20, s. 2425-2435. https://doi.org/10.1056/NEJMoa2211868

APA

Andersen-Ranberg, N. C., Poulsen, L. M., Perner, A., Wetterslev, J., Estrup, S., Haestbacka, J., Morgan, M., Citerio, G., Caballero, J., Lange, T., Kjaer, M-B. N., Ebdrup, B. H., Engstrom, J., Olsen, M. H., Oxenboll Collet, M., Mortensen, C. B., Weber, S-O., Andreasen, A. S., Bestle, M. H., ... AID ICU Trial Grp (2022). Haloperidol for the Treatment of Delirium in ICU Patients. New England Journal of Medicine, 387(20), 2425-2435. https://doi.org/10.1056/NEJMoa2211868

Vancouver

Andersen-Ranberg NC, Poulsen LM, Perner A, Wetterslev J, Estrup S, Haestbacka J o.a. Haloperidol for the Treatment of Delirium in ICU Patients. New England Journal of Medicine. 2022;387(20):2425-2435. https://doi.org/10.1056/NEJMoa2211868

Author

Andersen-Ranberg, Nina C. ; Poulsen, Lone M. ; Perner, Anders ; Wetterslev, Jørn ; Estrup, Stine ; Haestbacka, Johanna ; Morgan, Matt ; Citerio, Giuseppe ; Caballero, Jesus ; Lange, Theis ; Kjaer, Maj-Brit N. ; Ebdrup, Bjorn H. ; Engstrom, Janus ; Olsen, Markus H. ; Oxenboll Collet, Marie ; Mortensen, Camilla B. ; Weber, Sven-Olaf ; Andreasen, A. Sofie ; Bestle, Morten H. ; Uslu, Buelent ; Scharling Pedersen, Helle ; Gramstrup Nielsen, Louise ; Toft Boesen, Hans C. ; Jensen, Jacob V. ; Nebrich, Lars ; La Cour, Kirstine ; Laigaard, Jens ; Haurum, Cecilie ; Olesen, Marie W. ; Overgaard-Steensen, Christian ; Westergaard, Bo ; Brand, Bjorn A. ; Kingo Vesterlund, Gitte ; Thornberg Kyhnauv, Pernille ; Mikkelsen, Vibe S. ; Hyttel-Sorensen, Simon ; de Haas, Inge ; Aagaard, Soren R. ; Nielsen, Line O. ; Eriksen, Anne S. ; Rasmussen, Bodil S. ; Brix, Helene ; Hildebrandt, Thomas ; Schonemann-Lund, Martin ; Fjeldsoe-Nielsen, Hans ; Kuivalainen, Anna-Maria ; Mathiesen, Ole ; AID ICU Trial Grp. / Haloperidol for the Treatment of Delirium in ICU Patients. I: New England Journal of Medicine. 2022 ; Bind 387, Nr. 20. s. 2425-2435.

Bibtex

@article{1475d89e167540fb88fa5776182481ed,

title = "Haloperidol for the Treatment of Delirium in ICU Patients",

abstract = "BACKGROUND Haloperidol is frequently used to treat delirium in patients in the intensive care unit (ICU), but evidence of its effect is limited. METHODS In this multicenter, blinded, placebo-controlled trial, we randomly assigned adult patients with delirium who had been admitted to the ICU for an acute condition to receive intravenous haloperidol (2.5 mg 3 times daily plus 2.5 mg as needed up to a total maximum daily dose of 20 mg) or placebo. Haloperidol or placebo was administered in the ICU for as long as delirium continued and as needed for recurrences. The primary outcome was the number of days alive and out of the hospital at 90 days after randomization. RESULTS A total of 1000 patients underwent randomization; 510 were assigned to the haloperidol group and 490 to the placebo group. Among these patients, 987 (98.7%) were included in the final analyses (501 in the haloperidol group and 486 in the placebo group). Primary outcome data were available for 963 patients (97.6%). At 90 days, the mean number of days alive and out of the hospital was 35.8 (95% confidence interval [CI], 32.9 to 38.6) in the haloperidol group and 32.9 (95% CI, 29.9 to 35.8) in the placebo group, with an adjusted mean difference of 2.9 days (95% CI, -1.2 to 7.0) (P=0.22). Mortality at 90 days was 36.3% in the haloperidol group and 43.3% in the placebo group (adjusted absolute difference, -6.9 percentage points [95% CI, -13.0 to -0.6]). Serious adverse reactions occurred in 11 patients in the haloperidol group and in 9 patients in the placebo group. CONCLUSIONS Among patients in the ICU with delirium, treatment with haloperidol did not lead to a significantly greater number of days alive and out of the hospital at 90 days than placebo.",

keywords = "INTENSIVE-CARE-UNIT, VALIDATION, MORTALITY",

author = "Andersen-Ranberg, {Nina C.} and Poulsen, {Lone M.} and Anders Perner and J{\o}rn Wetterslev and Stine Estrup and Johanna Haestbacka and Matt Morgan and Giuseppe Citerio and Jesus Caballero and Theis Lange and Kjaer, {Maj-Brit N.} and Ebdrup, {Bjorn H.} and Janus Engstrom and Olsen, {Markus H.} and {Oxenboll Collet}, Marie and Mortensen, {Camilla B.} and Sven-Olaf Weber and Andreasen, {A. Sofie} and Bestle, {Morten H.} and Buelent Uslu and {Scharling Pedersen}, Helle and {Gramstrup Nielsen}, Louise and {Toft Boesen}, {Hans C.} and Jensen, {Jacob V.} and Lars Nebrich and {La Cour}, Kirstine and Jens Laigaard and Cecilie Haurum and Olesen, {Marie W.} and Christian Overgaard-Steensen and Bo Westergaard and Brand, {Bjorn A.} and {Kingo Vesterlund}, Gitte and {Thornberg Kyhnauv}, Pernille and Mikkelsen, {Vibe S.} and Simon Hyttel-Sorensen and {de Haas}, Inge and Aagaard, {Soren R.} and Nielsen, {Line O.} and Eriksen, {Anne S.} and Rasmussen, {Bodil S.} and Helene Brix and Thomas Hildebrandt and Martin Schonemann-Lund and Hans Fjeldsoe-Nielsen and Anna-Maria Kuivalainen and Ole Mathiesen and {AID ICU Trial Grp}",

year = "2022",

doi = "10.1056/NEJMoa2211868",

language = "English",

volume = "387",

pages = "2425--2435",

journal = "New England Journal of Medicine",

issn = "0028-4793",

publisher = "Massachusetts Medical Society",

number = "20",

}

RIS

TY - JOUR

T1 - Haloperidol for the Treatment of Delirium in ICU Patients

AU - Andersen-Ranberg, Nina C.

AU - Poulsen, Lone M.

AU - Perner, Anders

AU - Wetterslev, Jørn

AU - Estrup, Stine

AU - Haestbacka, Johanna

AU - Morgan, Matt

AU - Citerio, Giuseppe

AU - Caballero, Jesus

AU - Lange, Theis

AU - Kjaer, Maj-Brit N.

AU - Ebdrup, Bjorn H.

AU - Engstrom, Janus

AU - Olsen, Markus H.

AU - Oxenboll Collet, Marie

AU - Mortensen, Camilla B.

AU - Weber, Sven-Olaf

AU - Andreasen, A. Sofie

AU - Bestle, Morten H.

AU - Uslu, Buelent

AU - Scharling Pedersen, Helle

AU - Gramstrup Nielsen, Louise

AU - Toft Boesen, Hans C.

AU - Jensen, Jacob V.

AU - Nebrich, Lars

AU - La Cour, Kirstine

AU - Laigaard, Jens

AU - Haurum, Cecilie

AU - Olesen, Marie W.

AU - Overgaard-Steensen, Christian

AU - Westergaard, Bo

AU - Brand, Bjorn A.

AU - Kingo Vesterlund, Gitte

AU - Thornberg Kyhnauv, Pernille

AU - Mikkelsen, Vibe S.

AU - Hyttel-Sorensen, Simon

AU - de Haas, Inge

AU - Aagaard, Soren R.

AU - Nielsen, Line O.

AU - Eriksen, Anne S.

AU - Rasmussen, Bodil S.

AU - Brix, Helene

AU - Hildebrandt, Thomas

AU - Schonemann-Lund, Martin

AU - Fjeldsoe-Nielsen, Hans

AU - Kuivalainen, Anna-Maria

AU - Mathiesen, Ole

AU - AID ICU Trial Grp, null

PY - 2022

Y1 - 2022

N2 - BACKGROUND Haloperidol is frequently used to treat delirium in patients in the intensive care unit (ICU), but evidence of its effect is limited. METHODS In this multicenter, blinded, placebo-controlled trial, we randomly assigned adult patients with delirium who had been admitted to the ICU for an acute condition to receive intravenous haloperidol (2.5 mg 3 times daily plus 2.5 mg as needed up to a total maximum daily dose of 20 mg) or placebo. Haloperidol or placebo was administered in the ICU for as long as delirium continued and as needed for recurrences. The primary outcome was the number of days alive and out of the hospital at 90 days after randomization. RESULTS A total of 1000 patients underwent randomization; 510 were assigned to the haloperidol group and 490 to the placebo group. Among these patients, 987 (98.7%) were included in the final analyses (501 in the haloperidol group and 486 in the placebo group). Primary outcome data were available for 963 patients (97.6%). At 90 days, the mean number of days alive and out of the hospital was 35.8 (95% confidence interval [CI], 32.9 to 38.6) in the haloperidol group and 32.9 (95% CI, 29.9 to 35.8) in the placebo group, with an adjusted mean difference of 2.9 days (95% CI, -1.2 to 7.0) (P=0.22). Mortality at 90 days was 36.3% in the haloperidol group and 43.3% in the placebo group (adjusted absolute difference, -6.9 percentage points [95% CI, -13.0 to -0.6]). Serious adverse reactions occurred in 11 patients in the haloperidol group and in 9 patients in the placebo group. CONCLUSIONS Among patients in the ICU with delirium, treatment with haloperidol did not lead to a significantly greater number of days alive and out of the hospital at 90 days than placebo.

AB - BACKGROUND Haloperidol is frequently used to treat delirium in patients in the intensive care unit (ICU), but evidence of its effect is limited. METHODS In this multicenter, blinded, placebo-controlled trial, we randomly assigned adult patients with delirium who had been admitted to the ICU for an acute condition to receive intravenous haloperidol (2.5 mg 3 times daily plus 2.5 mg as needed up to a total maximum daily dose of 20 mg) or placebo. Haloperidol or placebo was administered in the ICU for as long as delirium continued and as needed for recurrences. The primary outcome was the number of days alive and out of the hospital at 90 days after randomization. RESULTS A total of 1000 patients underwent randomization; 510 were assigned to the haloperidol group and 490 to the placebo group. Among these patients, 987 (98.7%) were included in the final analyses (501 in the haloperidol group and 486 in the placebo group). Primary outcome data were available for 963 patients (97.6%). At 90 days, the mean number of days alive and out of the hospital was 35.8 (95% confidence interval [CI], 32.9 to 38.6) in the haloperidol group and 32.9 (95% CI, 29.9 to 35.8) in the placebo group, with an adjusted mean difference of 2.9 days (95% CI, -1.2 to 7.0) (P=0.22). Mortality at 90 days was 36.3% in the haloperidol group and 43.3% in the placebo group (adjusted absolute difference, -6.9 percentage points [95% CI, -13.0 to -0.6]). Serious adverse reactions occurred in 11 patients in the haloperidol group and in 9 patients in the placebo group. CONCLUSIONS Among patients in the ICU with delirium, treatment with haloperidol did not lead to a significantly greater number of days alive and out of the hospital at 90 days than placebo.

KW - INTENSIVE-CARE-UNIT

KW - VALIDATION

KW - MORTALITY

U2 - 10.1056/NEJMoa2211868

DO - 10.1056/NEJMoa2211868

M3 - Journal article

C2 - 36286254

VL - 387

SP - 2425

EP - 2435

JO - New England Journal of Medicine

JF - New England Journal of Medicine

SN - 0028-4793

IS - 20

ER -

ID: 324496522