2019
DOI: 10.5863/1551-6776-24.3.204
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Antipsychotic Treatment of Delirium in Critically Ill Children: A Retrospective Matched Cohort Study

Abstract: OBJECTIVE To describe the use of pharmacologic treatment in critically ill children treated according to a delirium protocol and compare those treated with antipsychotics to those treated non-pharmacologically. METHODS The study included a retrospective matched cohort describing patients who were pharmacologically treated for delirium compared to those with delirium but not treated in a PICU from December 2013 to September 2015, using a delirium management protocol. Patients were matched by age,… Show more

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Cited by 13 publications
(33 citation statements)
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“…Antipsychotics (haloperidol, chlorpromazine, risperidone, olanzapine, and quetiapine) are useful treatments for refractory delirium [ 181 ]. First-generation antipsychotics, such as haloperidol and chlorpromazine, have high rates of extrapyramidal symptoms (EPS) due to their strong dopamine D 2 antagonism [ 181 ]. Haloperidol is popular in the critical care setting because of its IV formulation.…”
Section: Sedationmentioning
confidence: 99%
See 2 more Smart Citations
“…Antipsychotics (haloperidol, chlorpromazine, risperidone, olanzapine, and quetiapine) are useful treatments for refractory delirium [ 181 ]. First-generation antipsychotics, such as haloperidol and chlorpromazine, have high rates of extrapyramidal symptoms (EPS) due to their strong dopamine D 2 antagonism [ 181 ]. Haloperidol is popular in the critical care setting because of its IV formulation.…”
Section: Sedationmentioning
confidence: 99%
“…Second-generation antipsychotics such as risperidone, olanzapine, and quetiapine have lower rates of EPS and tardive dyskinesia but with long term use they are associated with an increased risk of weight gain, metabolic side effects, and dyslipidemia. Risperidone and quetiapine are often favored for their favorable side effect profile in the treatment of delirium [ 181 , 182 , 183 ].…”
Section: Sedationmentioning
confidence: 99%
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“…Antipsychotics can be helpful for symptomatic management when a child continues to experience delirium despite the optimal management of the underlying illness and minimizing iatrogenic triggers. Although this represents offlabel use, quetiapine was shown to be safe and effective in a randomized controlled trial [61], and case studies suggest the same for risperidone and olanzapine [62][63][64].…”
Section: Delirium: Assess Prevent and Managementioning
confidence: 99%
“…Typical (haloperidol) and atypical antipsychotics (risperidone, olanzapine, quetiapine) have been studied for the management of pediatric delirium focusing on both efficacy and safety. 2-5,9-12 Very few patients <2 years old were included in these studies or dosing was described for the entire study population with no specific data for younger infants. Based on the data available, there is no universally accepted agent recommended for treatment of PICU delirium.…”
Section: Discussionmentioning
confidence: 99%