Comparison of the Effects of Haloperidol and Dexmedetomidine on Delirium and Agitation in Patients with a Traumatic Brain Injury Admitted to the Intensive Care Unit.

Abstract

BackgroundPatients under mechanical ventilation in the Intensive Care Unit (ICU) have a higher risk of delirium. To date, the ideal sedative combination for delirium treatment in terms of cost and side effects has not been determined.ObjectivesThis study was designed to compare the effects of haloperidol and dexmedetomidine on delirium in trauma patients under mechanical ventilation in the ICU.MethodsSixty patients with a moderate traumatic brain injury were randomly divided into two groups. Patients in the haloperidol group received 2.5 mg of haloperidol intravenously every eight hours for ten minutes daily, and the dexmedetomidine group received 0.5 µg/kg of dexmedetomidine via intravenous infusion every other day. Delirium, agitation, length of hospitalization, duration of mechanical ventilation, and need for sedation up to seven days were measured and recorded in both groups. The Richmond Agitation-Sedation scale (RASS) and Acute Physiology and Chronic Health evaluation (APACHE II) scales were used to determine the level of agitation in patients. The Confusion Assessment method (CAM)-ICU criteria were used to determine the incidence of delirium.ResultsBased on the results of this study, age and sex of the two groups were not significantly different. The mean age of the patients was 36.83 years in the haloperidol group and 40.1 years in the dexmedetomidine group. After the intervention, there was no significant difference in terms of the level of consciousness, number of days required for ventilation (P = 0.17), and number of days in the ICU (P = 0.49); however, there was a significant difference between the two groups three to seven days after the intervention. Besides, there was a significant difference between the two groups regarding the incidence of delirium five to seven days after the intervention (P < 0.05).ConclusionsThere was a significant difference between the two groups in terms of the incidence of delirium and the level of agitation; the patients in the dexmedetomidine group were calmer and experienced less delirium.