Cargando…

Efficacy of Low-Dose Prophylactic Quetiapine on Delirium Prevention in Critically Ill Patients: A Prospective, Randomized, Double-Blind, Placebo-Controlled Study

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 intensi...

Descripción completa

Detalles Bibliográficos
Autores principales: Kim, Youlim, Kim, Hyung-Sook, Park, Jong Sun, Cho, Young-Jae, Yoon, Ho Il, Lee, Sang-Min, Lee, Jae Ho, Lee, Choon-Taek, Lee, Yeon Joo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7019813/
https://www.ncbi.nlm.nih.gov/pubmed/31892105
http://dx.doi.org/10.3390/jcm9010069
_version_ 1783497606300696576
author Kim, Youlim
Kim, Hyung-Sook
Park, Jong Sun
Cho, Young-Jae
Yoon, Ho Il
Lee, Sang-Min
Lee, Jae Ho
Lee, Choon-Taek
Lee, Yeon Joo
author_facet Kim, Youlim
Kim, Hyung-Sook
Park, Jong Sun
Cho, Young-Jae
Yoon, Ho Il
Lee, Sang-Min
Lee, Jae Ho
Lee, Choon-Taek
Lee, Yeon Joo
author_sort Kim, Youlim
collection PubMed
description 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.
format Online
Article
Text
id pubmed-7019813
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-70198132020-03-09 Efficacy of Low-Dose Prophylactic Quetiapine on Delirium Prevention in Critically Ill Patients: A Prospective, Randomized, Double-Blind, Placebo-Controlled Study Kim, Youlim Kim, Hyung-Sook Park, Jong Sun Cho, Young-Jae Yoon, Ho Il Lee, Sang-Min Lee, Jae Ho Lee, Choon-Taek Lee, Yeon Joo J Clin Med Article 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. MDPI 2019-12-27 /pmc/articles/PMC7019813/ /pubmed/31892105 http://dx.doi.org/10.3390/jcm9010069 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Kim, Youlim
Kim, Hyung-Sook
Park, Jong Sun
Cho, Young-Jae
Yoon, Ho Il
Lee, Sang-Min
Lee, Jae Ho
Lee, Choon-Taek
Lee, Yeon Joo
Efficacy of Low-Dose Prophylactic Quetiapine on Delirium Prevention in Critically Ill Patients: A Prospective, Randomized, Double-Blind, Placebo-Controlled Study
title Efficacy of Low-Dose Prophylactic Quetiapine on Delirium Prevention in Critically Ill Patients: A Prospective, Randomized, Double-Blind, Placebo-Controlled Study
title_full Efficacy of Low-Dose Prophylactic Quetiapine on Delirium Prevention in Critically Ill Patients: A Prospective, Randomized, Double-Blind, Placebo-Controlled Study
title_fullStr Efficacy of Low-Dose Prophylactic Quetiapine on Delirium Prevention in Critically Ill Patients: A Prospective, Randomized, Double-Blind, Placebo-Controlled Study
title_full_unstemmed Efficacy of Low-Dose Prophylactic Quetiapine on Delirium Prevention in Critically Ill Patients: A Prospective, Randomized, Double-Blind, Placebo-Controlled Study
title_short Efficacy of Low-Dose Prophylactic Quetiapine on Delirium Prevention in Critically Ill Patients: A Prospective, Randomized, Double-Blind, Placebo-Controlled Study
title_sort efficacy of low-dose prophylactic quetiapine on delirium prevention in critically ill patients: a prospective, randomized, double-blind, placebo-controlled study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7019813/
https://www.ncbi.nlm.nih.gov/pubmed/31892105
http://dx.doi.org/10.3390/jcm9010069
work_keys_str_mv AT kimyoulim efficacyoflowdoseprophylacticquetiapineondeliriumpreventionincriticallyillpatientsaprospectiverandomizeddoubleblindplacebocontrolledstudy
AT kimhyungsook efficacyoflowdoseprophylacticquetiapineondeliriumpreventionincriticallyillpatientsaprospectiverandomizeddoubleblindplacebocontrolledstudy
AT parkjongsun efficacyoflowdoseprophylacticquetiapineondeliriumpreventionincriticallyillpatientsaprospectiverandomizeddoubleblindplacebocontrolledstudy
AT choyoungjae efficacyoflowdoseprophylacticquetiapineondeliriumpreventionincriticallyillpatientsaprospectiverandomizeddoubleblindplacebocontrolledstudy
AT yoonhoil efficacyoflowdoseprophylacticquetiapineondeliriumpreventionincriticallyillpatientsaprospectiverandomizeddoubleblindplacebocontrolledstudy
AT leesangmin efficacyoflowdoseprophylacticquetiapineondeliriumpreventionincriticallyillpatientsaprospectiverandomizeddoubleblindplacebocontrolledstudy
AT leejaeho efficacyoflowdoseprophylacticquetiapineondeliriumpreventionincriticallyillpatientsaprospectiverandomizeddoubleblindplacebocontrolledstudy
AT leechoontaek efficacyoflowdoseprophylacticquetiapineondeliriumpreventionincriticallyillpatientsaprospectiverandomizeddoubleblindplacebocontrolledstudy
AT leeyeonjoo efficacyoflowdoseprophylacticquetiapineondeliriumpreventionincriticallyillpatientsaprospectiverandomizeddoubleblindplacebocontrolledstudy