November 26, 2018

Background Information: Delirium is defined as an acute disorder of consciousness which can occur in up to 80% of mechanically ventilated ICU patients.1-5 This acute cognitive dysfunction is associated with prolonged hospital stay, increased mortality, longer periods of mechanical ventilation and long-term cognitive impairment compared to patients without delirium.4-8  Haloperidol, remains one of the most commonly used typical antipsychotics used to treat delirium internationally and within the United States.9,10 The Society of Critical Care Medicine’s recent guidelines do not suggest the use of Haloperidol in the prevention or treatment of delirium11 and understandably so as two randomized trials showed no reduction in duration of ICU delirium.5,12 Alternative therapies for delirium include atypical antipsychotics such as ziprasidone, however the literature shows conflicting evidence, with one study showing a benefit and another showing no effect.5,13 The authors of this study sought to examine the effects of these two treatments in a large multicenter, randomized, double-blinded, placebo-controlled trial.