氟哌啶醇预防能否降低重症监护病房危重症患者谵妄的发生率？系统评价和荟萃分析。
Can haloperidol prophylaxis reduce the incidence of delirium in critically ill patients in intensive care units? A systematic review and meta-analysis.
机构信息
Department of Respiratory and Critical Care Medicine, West China School of Medicine and West China Hospital, Sichuan University, Chengdu 610041, China.
Department of Respiratory and Critical Care Medicine, West China School of Medicine and West China Hospital, Sichuan University, Chengdu 610041, China.
出版信息
Heart Lung. 2020 May-Jun;49(3):265-272. doi: 10.1016/j.hrtlng.2020.01.010. Epub 2020 Feb 5.
INTRODUCTION
The purpose of this study was to evaluate the efficacy and safety of haloperidol in the prevention of delirium in intensive care unit (ICU) patients.
METHODS
We systematically searched PubMed, Embase, and the Cochrane Library for eligible randomized controlled trials up to July 2019. No publication type or language restrictions were applied.
RESULTS
Compared to the placebo, haloperidol did not significantly reduce the incidence of delirium in all ICU patients (relative risk (RR), 0.83; 95% confidence interval (CI), 0.62-1.10, p = 0.20). However, haloperidol prophylaxis could reduce the incidence of delirium exclusively in postoperative patients admitted to an ICU (RR, 0.63; 95% CI, 0.47-0.86, p = 0.004). We observed no significant differences between the haloperidol and placebo groups in terms of length of ICU stay, all-cause mortality, and adverse events.
CONCLUSIONS
The use of prophylactic haloperidol might reduce the incidence of delirium in postoperative patients admitted to an ICU, but not in all ICU patients.
介绍
本研究旨在评估氟哌啶醇预防重症监护病房（ICU）患者谵妄的疗效和安全性。
方法
我们系统地检索了 PubMed、Embase 和 Cochrane 图书馆，以获取截至 2019 年 7 月的合格随机对照试验。未对发表类型或语言进行限制。
结果
与安慰剂相比，氟哌啶醇并不能显著降低所有 ICU 患者的谵妄发生率（相对风险（RR），0.83；95%置信区间（CI），0.62-1.10，p=0.20）。然而，氟哌啶醇预防治疗可以显著降低 ICU 术后患者的谵妄发生率（RR，0.63；95%CI，0.47-0.86，p=0.004）。在 ICU 住院时间、全因死亡率和不良事件方面，氟哌啶醇组与安慰剂组之间无显著差异。
结论
预防性使用氟哌啶醇可能会降低 ICU 术后患者的谵妄发生率，但不会降低所有 ICU 患者的谵妄发生率。
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