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:
Seoul Natl Univ, Bundang Hosp, Div Pulm & Crit Care Med, Dept Internal Med, Seongnam Si, South KoreaSeoul Natl Univ, Bundang Hosp, Div Pulm & Crit Care Med, Dept Internal Med, Seongnam Si, South Korea
Kim, Y.
Kim, H.
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Seoul Natl Univ, Bundang Hosp, Dept Pharm, Seongnam Si, South KoreaSeoul Natl Univ, Bundang Hosp, Div Pulm & Crit Care Med, Dept Internal Med, Seongnam Si, South Korea
Kim, H.
Lee, S.
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Seoul Natl Univ, Bundang Hosp, Div Pulm & Crit Care Med, Dept Internal Med, Seongnam Si, South KoreaSeoul Natl Univ, Bundang Hosp, Div Pulm & Crit Care Med, Dept Internal Med, Seongnam Si, South Korea
Lee, S.
Park, J.
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Seoul Natl Univ, Bundang Hosp, Div Pulm & Crit Care Med, Dept Internal Med, Seongnam Si, South KoreaSeoul Natl Univ, Bundang Hosp, Div Pulm & Crit Care Med, Dept Internal Med, Seongnam Si, South Korea
Park, J.
Cho, Y.
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Seoul Natl Univ, Bundang Hosp, Div Pulm & Crit Care Med, Dept Internal Med, Seongnam Si, South KoreaSeoul Natl Univ, Bundang Hosp, Div Pulm & Crit Care Med, Dept Internal Med, Seongnam Si, South Korea
Cho, Y.
Yoon, H.
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Seoul Natl Univ, Bundang Hosp, Div Pulm & Crit Care Med, Dept Internal Med, Seongnam Si, South KoreaSeoul Natl Univ, Bundang Hosp, Div Pulm & Crit Care Med, Dept Internal Med, Seongnam Si, South Korea
Yoon, H.
Lee, J.
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机构:
Seoul Natl Univ, Bundang Hosp, Div Pulm & Crit Care Med, Dept Internal Med, Seongnam Si, South KoreaSeoul Natl Univ, Bundang Hosp, Div Pulm & Crit Care Med, Dept Internal Med, Seongnam Si, South Korea
Lee, J.
Lee, C.
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Seoul Natl Univ, Bundang Hosp, Div Pulm & Crit Care Med, Dept Internal Med, Seongnam Si, South KoreaSeoul Natl Univ, Bundang Hosp, Div Pulm & Crit Care Med, Dept Internal Med, Seongnam Si, South Korea
Lee, C.
Lee, Y.
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Seoul Natl Univ, Bundang Hosp, Div Pulm & Crit Care Med, Dept Internal Med, Seongnam Si, South KoreaSeoul Natl Univ, Bundang Hosp, Div Pulm & Crit Care Med, Dept Internal Med, Seongnam Si, South Korea
机构:
Northeastern Univ, Sch Pharm, Boston, MA 02115 USA
Tufts Med Ctr, Div Pulm Crit Care & Sleep Med, Boston, MA 02111 USANortheastern Univ, Sch Pharm, Boston, MA 02115 USA
Devlin, John W.
Skrobik, Yoanna
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机构:
Hop Maisoneuve Rosemont, Dept Crit Care Med, Montreal, PQ H1T 2M4, CanadaNortheastern Univ, Sch Pharm, Boston, MA 02115 USA
Skrobik, Yoanna
Riker, Richard R.
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Maine Med Ctr, Dept Crit Care Med, Portland, ME 04102 USANortheastern Univ, Sch Pharm, Boston, MA 02115 USA
Riker, Richard R.
Hinderleider, Eric
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Northeastern Univ, Sch Pharm, Boston, MA 02115 USANortheastern Univ, Sch Pharm, Boston, MA 02115 USA
Hinderleider, Eric
Roberts, Russel J.
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机构:
Tufts Med Ctr, Dept Pharm, Boston, MA 02111 USANortheastern Univ, Sch Pharm, Boston, MA 02115 USA
Roberts, Russel J.
Fong, Jeffrey J.
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机构:
Massachusetts Coll Pharm & Hlth Sci, Dept Pharm Practice, Worcester, MA 01608 USANortheastern Univ, Sch Pharm, Boston, MA 02115 USA
Fong, Jeffrey J.
Ruthazer, Robin
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机构:
Tufts Med Ctr, Biostat Res Ctr, Inst Clin Res & Hlth Policy Studies, Boston, MA 02111 USANortheastern Univ, Sch Pharm, Boston, MA 02115 USA
Ruthazer, Robin
Hill, Nicholas S.
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机构:
Tufts Med Ctr, Div Pulm Crit Care & Sleep Med, Boston, MA 02111 USANortheastern Univ, Sch Pharm, Boston, MA 02115 USA
Hill, Nicholas S.
Garpestad, Erik
论文数: 0引用数: 0
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机构:
Tufts Med Ctr, Div Pulm Crit Care & Sleep Med, Boston, MA 02111 USANortheastern Univ, Sch Pharm, Boston, MA 02115 USA