Efficacy of Low-Dose Prophylactic Quetiapine on Delirium Prevention in Critically Ill Patients: A Prospective, Randomized, Double-Blind, Placebo-Controlled Study
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Kim, Youlim
[1
]
Kim, Hyung-Sook
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Seoul Natl Univ, Bundang Hosp, Dept Pharm, Seongnam Si 13620, Gyeonggi Do, South KoreaHallym Univ, Chuncheon Sacred Heart Hosp, Dept Internal Med, Div Pulm Allergy & Crit Care Med, Chuncheon Si 24253, Gangwon Do, South Korea
Kim, Hyung-Sook
[2
]
Park, Jong Sun
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Seoul Natl Univ, Bundang Hosp, Dept Internal Med, Div Pulm & Crit Care Med, Seongnam Si 13620, Gyeonggi Do, South KoreaHallym Univ, Chuncheon Sacred Heart Hosp, Dept Internal Med, Div Pulm Allergy & Crit Care Med, Chuncheon Si 24253, Gangwon Do, South Korea
Park, Jong Sun
[3
]
Cho, Young-Jae
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Seoul Natl Univ, Bundang Hosp, Dept Internal Med, Div Pulm & Crit Care Med, Seongnam Si 13620, Gyeonggi Do, South KoreaHallym Univ, Chuncheon Sacred Heart Hosp, Dept Internal Med, Div Pulm Allergy & Crit Care Med, Chuncheon Si 24253, Gangwon Do, South Korea
Cho, Young-Jae
[3
]
Yoon, Ho Il
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Seoul Natl Univ, Bundang Hosp, Dept Internal Med, Div Pulm & Crit Care Med, Seongnam Si 13620, Gyeonggi Do, South KoreaHallym Univ, Chuncheon Sacred Heart Hosp, Dept Internal Med, Div Pulm Allergy & Crit Care Med, Chuncheon Si 24253, Gangwon Do, South Korea
Yoon, Ho Il
[3
]
Lee, Sang-Min
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Seoul Natl Univ Hosp, Dept Internal Med, Div Pulm & Crit Care Med, Seoul 03080, South KoreaHallym Univ, Chuncheon Sacred Heart Hosp, Dept Internal Med, Div Pulm Allergy & Crit Care Med, Chuncheon Si 24253, Gangwon Do, South Korea
Lee, Sang-Min
[4
]
Lee, Jae Ho
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Seoul Natl Univ, Bundang Hosp, Dept Internal Med, Div Pulm & Crit Care Med, Seongnam Si 13620, Gyeonggi Do, South KoreaHallym Univ, Chuncheon Sacred Heart Hosp, Dept Internal Med, Div Pulm Allergy & Crit Care Med, Chuncheon Si 24253, Gangwon Do, South Korea
Lee, Jae Ho
[3
]
Lee, Choon-Taek
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Seoul Natl Univ, Bundang Hosp, Dept Internal Med, Div Pulm & Crit Care Med, Seongnam Si 13620, Gyeonggi Do, South KoreaHallym Univ, Chuncheon Sacred Heart Hosp, Dept Internal Med, Div Pulm Allergy & Crit Care Med, Chuncheon Si 24253, Gangwon Do, South Korea
Lee, Choon-Taek
[3
]
Lee, Yeon Joo
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Seoul Natl Univ, Bundang Hosp, Dept Internal Med, Div Pulm & Crit Care Med, Seongnam Si 13620, Gyeonggi Do, South KoreaHallym Univ, Chuncheon Sacred Heart Hosp, Dept Internal Med, Div Pulm Allergy & Crit Care Med, Chuncheon Si 24253, Gangwon Do, South Korea
Lee, Yeon Joo
[3
]
机构:
[1] Hallym Univ, Chuncheon Sacred Heart Hosp, Dept Internal Med, Div Pulm Allergy & Crit Care Med, Chuncheon Si 24253, Gangwon Do, South Korea
[2] Seoul Natl Univ, Bundang Hosp, Dept Pharm, Seongnam Si 13620, Gyeonggi Do, South Korea
[3] Seoul Natl Univ, Bundang Hosp, Dept Internal Med, Div Pulm & Crit Care Med, Seongnam Si 13620, Gyeonggi Do, South Korea
[4] Seoul Natl Univ Hosp, Dept Internal Med, Div Pulm & Crit Care Med, Seoul 03080, South Korea
delirium;
prevention;
quetiapine;
medical intensive care unit;
extubation;
INTENSIVE-CARE-UNIT;
MECHANICALLY VENTILATED PATIENTS;
TERM COGNITIVE IMPAIRMENT;
HALOPERIDOL PROPHYLAXIS;
POSTOPERATIVE DELIRIUM;
ELDERLY-PATIENTS;
RISK;
MORTALITY;
DURATION;
SURGERY;
D O I:
10.3390/jcm9010069
中图分类号:
R5 [内科学];
学科分类号:
1002 ;
100201 ;
摘要:
Purpose: To evaluate the efficacy of short-term low-dose quetiapine for delirium prevention in critically ill patients. Methods: In this prospective, a single-center, randomized, double-blind, placebo-controlled trial, adult patients who were admitted from July 2015 to July 2017 to a medical intensive care unit (ICU) of a tertiary teaching hospital affiliated to Seoul National University were included. Quetiapine (12.5 mg or 25 mg oral at night; N = 16) or placebo (N = 21) was administered according to randomization until ICU discharge or the 10th ICU day. The primary endpoint was the incidence of delirium within the first 10 ICU days. Secondary endpoints included the rate of positive Confusion Assessment Method for the ICU (CAM-ICU) (the number of positive CAM-ICU counts/the number of total CAM-ICU counts), delirium duration, successful extubation, and overall mortality. Result: The incidence of delirium during the 10 days after ICU admission was 46.7% (7/15) in the quetiapine group and 55.0% (11/20) in the placebo group (p = 0.442). In the quetiapine group, the rate of positive CAM-ICU was significantly lower than in the placebo group (14.4% vs. 37.4%, p = 0.048), delirium duration during the study period was significantly shorter (0.28 day vs. 1.83 days, p = 0.018), and more patients in the quetiapine than in the placebo group were weaned from mechanical ventilation successfully (84.6% vs. 47.1%, p = 0.040). Conclusions: Our study suggests that prophylactic use of low-dose quetiapine could be helpful for preventing delirium in critically ill patients. A further large-scale prospective study is needed.
机构:
Northeastern Univ, Sch Pharm, Boston, MA 02115 USANortheastern Univ, Sch Pharm, Boston, MA 02115 USA
Al-Qadheeb, Nada S.
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Skrobik, Yoanna
Schumaker, Greg
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Tufts Med Ctr, Div Pulm Crit Care & Sleep Med, Boston, MA USANortheastern Univ, Sch Pharm, Boston, MA 02115 USA
Schumaker, Greg
Pacheco, Manuel N.
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Tufts Med Ctr, Dept Psychiat, Boston, MA USANortheastern Univ, Sch Pharm, Boston, MA 02115 USA
Pacheco, Manuel N.
Roberts, Russel J.
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Tufts Med Ctr, Dept Pharm, Boston, MA USANortheastern Univ, Sch Pharm, Boston, MA 02115 USA
Roberts, Russel J.
Ruthazer, Robin R.
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机构:
Tufts Med Ctr, Tufts Clin & Translat Sci Inst, Res Design Ctr, Boston, MA USA
Tufts Med Ctr, Tufts Clin & Translat Sci Inst, Biostat Res Ctr, Boston, MA USANortheastern Univ, Sch Pharm, Boston, MA 02115 USA
Ruthazer, Robin R.
Devlin, John W.
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机构:
Northeastern Univ, Sch Pharm, Boston, MA 02115 USA
Tufts Med Ctr, Div Pulm Crit Care & Sleep Med, Boston, MA USANortheastern Univ, Sch Pharm, Boston, MA 02115 USA
机构:
Zucker Hillside Hosp, Dept Psychiat, Glen Oaks, NY USAZucker Hillside Hosp, Dept Psychiat, Glen Oaks, NY USA
Kane, John M.
Silva, Robert
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h-index: 0
机构:
Sunovion Pharmaceut Inc, Clin Dev & Med Affairs, Marlborough, MA USA
Sunovion Pharmaceut Inc, Clin Dev & Med Affairs, Ft Lee, NJ USAZucker Hillside Hosp, Dept Psychiat, Glen Oaks, NY USA
Silva, Robert
Goldman, Robert
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机构:
Sunovion Pharmaceut Inc, Clin Dev & Med Affairs, Marlborough, MA USA
Sunovion Pharmaceut Inc, Clin Dev & Med Affairs, Ft Lee, NJ USAZucker Hillside Hosp, Dept Psychiat, Glen Oaks, NY USA
Goldman, Robert
Watabe, Kei
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机构:
Sunovion Pharmaceut Inc, Clin Dev & Med Affairs, Marlborough, MA USA
Sunovion Pharmaceut Inc, Clin Dev & Med Affairs, Ft Lee, NJ USAZucker Hillside Hosp, Dept Psychiat, Glen Oaks, NY USA
Watabe, Kei
Cucchiaro, Josephine
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机构:
Sunovion Pharmaceut Inc, Clin Dev & Med Affairs, Marlborough, MA USA
Sunovion Pharmaceut Inc, Clin Dev & Med Affairs, Ft Lee, NJ USAZucker Hillside Hosp, Dept Psychiat, Glen Oaks, NY USA
Cucchiaro, Josephine
Loebel, Antony
论文数: 0引用数: 0
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机构:
Sunovion Pharmaceut Inc, Clin Dev & Med Affairs, Marlborough, MA USA
Sunovion Pharmaceut Inc, Clin Dev & Med Affairs, Ft Lee, NJ USAZucker Hillside Hosp, Dept Psychiat, Glen Oaks, NY USA
机构:
Massachusetts Gen Hosp, Dept Psychiat, 55 Fruit St,Bulfinch 351, Boston, MA 02114 USAMassachusetts Gen Hosp, Dept Psychiat, 55 Fruit St,Bulfinch 351, Boston, MA 02114 USA
Fava, Maurizio
Durgam, Suresh
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Allergan Plc, Dept Clin Dev, Madison, NJ USAMassachusetts Gen Hosp, Dept Psychiat, 55 Fruit St,Bulfinch 351, Boston, MA 02114 USA
Durgam, Suresh
Earley, Willie
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Allergan Plc, Dept Clin Dev, Madison, NJ USAMassachusetts Gen Hosp, Dept Psychiat, 55 Fruit St,Bulfinch 351, Boston, MA 02114 USA
Earley, Willie
Lu, Kaifeng
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机构:
Allergan Plc, Dept Biostat, Madison, NJ USAMassachusetts Gen Hosp, Dept Psychiat, 55 Fruit St,Bulfinch 351, Boston, MA 02114 USA
Lu, Kaifeng
Hayes, Robert
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机构:
Allergan Plc, Dept Clin Dev, Madison, NJ USAMassachusetts Gen Hosp, Dept Psychiat, 55 Fruit St,Bulfinch 351, Boston, MA 02114 USA
Hayes, Robert
Laszlovszky, Istvan
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机构:
Gedeon Richter Plc, Med Div, Budapest, HungaryMassachusetts Gen Hosp, Dept Psychiat, 55 Fruit St,Bulfinch 351, Boston, MA 02114 USA
Laszlovszky, Istvan
Nemeth, Gyorgy
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机构:
Gedeon Richter Plc, Med Div, Budapest, HungaryMassachusetts Gen Hosp, Dept Psychiat, 55 Fruit St,Bulfinch 351, Boston, MA 02114 USA