评估喹硫平治疗成人重症监护病房谵妄的风险概况：一项回顾性研究。
Evaluating the risk profile of quetiapine in treating delirium in the intensive care adult population: A retrospective review.
机构信息
Department of Pharmacy, Medical University of South Carolina, 150 Ashley Ave., Charleston, SC, USA; Department of Pharmacy, Detroit Receiving Hospital - Detroit Medical Center, 4201 St. Antoine Blvd., Detroit, MI, USA.
Department of Pharmacy, Medical University of South Carolina, 150 Ashley Ave., Charleston, SC, USA.
出版信息
J Crit Care. 2018 Oct;47:169-172. doi: 10.1016/j.jcrc.2018.07.005. Epub 2018 Jul 5.
PURPOSE
Dosing regimens of quetiapine to treat delirium in critically ill patients are titrated to effect, and may utilize doses higher than previously reported. This study aimed to assess the safety of quetiapine for this indication.
MATERIALS AND METHODS
A retrospective medical chart review was conducted, identifying 154 critically ill adults that were initiated on quetiapine to treat delirium and monitored for QTc prolongation.
RESULTS
The median average daily dose was 150 mg (79-234) and median max dose was 225 mg (100-350). The overall range was 25-800 mg daily. The time to peak dose was 3 days (1-8). Patients with QTc prolongation were significantly older (age 54 ± 11 vs 45 ± 17 years (p = 0.002)) and with higher baseline QTc (454 ± 33 vs 442 ± 30 (p = 0.045)). Regression analysis revealed only dose as a significant factor (OR = 1.006 (1.003-1.009) (p < 0.001)).
CONCLUSION
The dose of quetiapine has very little correlation with QTc and change from baseline. A small number of side effects were observed. Overall, titrating quickly to large doses of quetiapine is safe for treating delirium.
目的
治疗重症患者谵妄的喹硫平剂量方案是根据疗效滴定的，可能使用的剂量高于先前报道的剂量。本研究旨在评估喹硫平治疗该适应症的安全性。
材料和方法
进行了回顾性病历审查，确定了 154 名接受喹硫平治疗谵妄并监测 QTc 延长的重症成人患者。
结果
中位平均日剂量为 150mg（79-234），中位最大剂量为 225mg（100-350）。总体范围为每日 25-800mg。达到峰值剂量的时间为 3 天（1-8）。出现 QTc 延长的患者明显更年长（年龄 54±11 岁与 45±17 岁（p=0.002）），基线 QTc 更高（454±33 毫秒与 442±30 毫秒（p=0.045））。回归分析显示，只有剂量是一个显著因素（OR=1.006（1.003-1.009）（p<0.001））。
结论
喹硫平的剂量与 QTc 变化几乎没有相关性。观察到少量副作用。总体而言，快速滴定至大剂量喹硫平治疗谵妄是安全的。
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