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Question 7#

Which of the statements is true regarding the choice of pharmacological agents for treatment of hypo- or hyperactive delirium in patients presenting with respiratory failure or shock?

A. Use of Haloperidol is associated with shorter duration of delirium when compared with placebo
B. Use of Ziprasidone is associated with shorter duration of delirium when compared with placebo
C. Use of Haloperidol is associated with shorter duration of delirium when compared with Ziprasidone
D. The use of either Haloperidol or Ziprasidone does not result in shorter duration of mechanical ventilation when compared to placebo

Correct Answer is D

Comment:

Correct Answer: D

The recently concluded MIND-ICU trial compared Ziprasidone and Haloperidol with placebo in the treatment of hypo- or hyperactive delirium in critically ill patients on mechanical ventilation. Of the patients, 90% had hypoactive delirium. There was no difference between the groups with regard to primary end points of delirium-free days. Secondary analyses revealed no difference between groups with regard to duration of mechanical ventilation, 30 or 90 day mortality, oversedation, or days to ICU discharge. Overall choice of antipsychotics Haloperidol or Ziprasidone did not improve outcomes when compared to placebo.

Reference:

1. Girard TD, Exline MC, Carson SS, et al. Haloperidol and ziprasidone for treatment of delirium in critical illness. N Engl J Med. 2018;379:2506- 2516