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重症监护病房谵妄治疗中氟哌啶醇与右美托咪定对QTc间期延长影响的比较分析

A Comparative Analysis of the Effects of Haloperidol and Dexmedetomidine on QTc Interval Prolongation during Delirium Treatment in Intensive Care Units.

作者信息

Haspolat Ali, Polat Fuat, Köprülü Ali Şefik

机构信息

Kolan International Hospital, İstanbul, Turkey.

Dr Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey.

出版信息

J Crit Care Med (Targu Mures). 2024 Jul 31;10(3):222-231. doi: 10.2478/jccm-2024-0027. eCollection 2024 Jul.

Abstract

BACKGROUND

Haloperidol and dexmedetomidine are used to treat delirium in the intensive care unit (ICU). The effects of these drugs on the corrected QT (QTc) interval have not been compared before. It was aimed to compare the effects of haloperidol and dexmedetomidine treatment on QTc intervals in patients who developed delirium during ICU follow-up.

METHOD

The study is single-center, randomized, and prospective. Half of the patients diagnosed with delirium in the ICU were treated with haloperidol and the other half with dexmedetomidine. The QTc interval was measured in the treatment groups before and after drug treatment. The study's primary endpoints were maximal QT and QTc interval changes after drug administration.

RESULTS

90 patients were included in the study, the mean age was 75.2±12.9 years, and half were women. The mean time to delirium was 142+173.8 hours, and 53.3% of the patients died during their ICU follow-up. The most common reason for hospitalization in the ICU was sepsis (%37.8.). There was no significant change in QT and QTc interval after dexmedetomidine treatment (QT: 360.5±81.7, 352.0±67.0, p= 0.491; QTc: 409.4±63.1, 409.8±49.7, p=0.974). There was a significant increase in both QT and QTc interval after haloperidol treatment (QT: 363.2±51.1, 384.6±59.2, p=0.028; QTc: 409.4±50.9, 427.3±45.9, p=0.020).

CONCLUSIONS

Based on the results obtained from the study, it can be concluded that the administration of haloperidol was associated with a significant increase in QT and QTc interval. In contrast, the administration of dexmedetomidine did not cause a significant change in QT and QTc interval.

摘要

背景

氟哌啶醇和右美托咪定用于治疗重症监护病房(ICU)中的谵妄。此前尚未比较过这些药物对校正QT(QTc)间期的影响。本研究旨在比较氟哌啶醇和右美托咪定治疗对ICU随访期间发生谵妄患者QTc间期的影响。

方法

本研究为单中心、随机、前瞻性研究。ICU中诊断为谵妄的患者一半接受氟哌啶醇治疗,另一半接受右美托咪定治疗。在药物治疗前后测量治疗组的QTc间期。本研究的主要终点是给药后QT和QTc间期的最大变化。

结果

90例患者纳入研究,平均年龄为75.2±12.9岁,一半为女性。发生谵妄的平均时间为142+173.8小时,53.3%的患者在ICU随访期间死亡。ICU中最常见的住院原因是脓毒症(37.8%)。右美托咪定治疗后QT和QTc间期无显著变化(QT:360.5±81.7,352.0±67.0,p=0.491;QTc:409.4±63.1,409.8±49.7,p=0.974)。氟哌啶醇治疗后QT和QTc间期均显著增加(QT:363.2±51.1,384.6±59.2,p=0.028;QTc:409.4±50.9,427.3±45.9,p=0.020)。

结论

根据本研究获得的结果,可以得出结论,氟哌啶醇的给药与QT和QTc间期的显著增加有关。相比之下,右美托咪定的给药未导致QT和QTc间期的显著变化。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2441/11294981/952f6ad00ca4/j_jccm-2024-0027_fig_001.jpg

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