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Original Article

New England Journal of Medicine (10/26/22) DOI: 10.1056/NEJMoa2211868

Andersen-Ranberg, Nina C.; Poulsen, Lone M.; Perner, Anders; et al.

https://www.nejm.org/doi/full/10.1056/NEJMoa2211868

Summary

Researchers evaluated the effects of haloperidol on adult patients with delirium in the intensive care unit (ICU). The patients, who had been admitted to the ICU for an acute condition, were randomized to receive I.V. haloperidol (2.5 mg 3 times daily, plus 2.5 mg as needed up to a maximum daily dose of 20 mg) or placebo. The treatment or placebo was administered for as long as delirium continued and as needed for recurrent episodes. The final analyses included 501 patients in the haloperidol group and 486 in the placebo group. The primary outcome - the mean number of days alive and out of the hospital at 90 days after randomization - was 35.8 in the haloperidol group and 32.9 in the placebo group. Rates of mortality at that time were 36.3% and 43.3%, respectively. Serious adverse events occurred in 11 patients and nine patients, respectively. Based on their findings, the authors concluded that for ICU patients with delirium, "the use of haloperidol did not lead to a significantly greater number of days alive and out of the hospital at 90 days than placebo."

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