Li Matthew, Chang Mei H, Miranda-Valdes Yeismel, Vest Kirsten, Kish Troy D
Ment Health Clin. 2019 Jul 1;9(4):263-268. doi: 10.9740/mhc.2019.07.263. eCollection 2019 Jul.
Intensive care unit (ICU) delirium is a major contributing factor to increased mortality, length of stay, and cost of care. Psychotropic medications may often require extensive tapering to prevent withdrawal symptoms; during ICU admission, home psychotropics are frequently held which may precipitate acute drug withdrawal and subsequent delirium.
This is a single-center, observational, retrospective chart review. The primary endpoint was the total number of new-start antipsychotics used to treat ICU delirium. Secondary endpoints included use of restraints, ICU length of stay, and hospital length of stay.
A total of 2334 charts were reviewed for inclusion; 55 patients were categorized into each group. There was no statistically significant difference in the requirement for new-start antipsychotics ( = 1.0), restraint use ( = .057), or ICU length of stay ( = .71). There was a statistically significant decrease in hospital length of stay ( = .048).
Early reinitiation was associated with a decrease in hospital length of stay but was not associated with a decrease in the number of new-start antipsychotics, use of restraints, or ICU length of stay.
重症监护病房（ICU）谵妄是导致死亡率增加、住院时间延长和护理成本上升的主要因素。精神药物通常需要逐步减量以预防戒断症状；在入住ICU期间，经常停用家庭使用的精神药物，这可能会引发急性药物戒断及随后的谵妄。
这是一项单中心、观察性、回顾性病历审查。主要终点是用于治疗ICU谵妄的新启用抗精神病药物的总数。次要终点包括约束措施的使用、ICU住院时间和住院时间。
共审查了2334份病历以纳入研究；每组有55名患者。在新启用抗精神病药物的需求（=1.0）、约束措施的使用（=0.057）或ICU住院时间（=0.71）方面，无统计学显著差异。住院时间有统计学显著缩短（=0.048）。
早期重新启用与住院时间缩短相关，但与新启用抗精神病药物的数量减少、约束措施的使用或ICU住院时间缩短无关。
