Dec. 13 (UPI) -- A drug normally used for delirium in ICU is largely ineffective, pushing for a need for more personalized care, according to a study at Indiana University.
The research, published recently in the Journal of the American Geriatrics Society, shows that haloperidol and placebo each had the same effect on delirium incidence, or severity of delirium, in patients who underwent elective non-cardiac thoracic surgery, except on a few patients getting esophagectomies.
"Our work suggests that just as you can't lump all cancer patients together for treatment, you can't put all delirium patients in the same bucket," Dr. Babar A. Khan, who led the new study, said in a press release. "We need a personalized approach to delirium, focusing on people at higher risk of developing this complication."
Khan says he advises people considering elective surgery to talk with their primary care clinicians and their surgeon about the risks of delirium.
About five million people are taken to the ICU annually, and up to three-fourths of patients experience delirium, a condition that causes sudden confusion and other brain disruptions.
Conditions like sepsis, as well as liver and kidney disease, can cause delirium.
People suffering from delirium have a higher chance of a long hospital stay or dying up to a year after visiting a hospital. They also have a higher risk of losing physical functions and cognitive abilities.
"Because we now know that haloperidol, the most commonly used drug to treat ICU delirium, doesn't, with possibly few exceptions, work, we need to focus on nonpharmacological therapies and vigilantly curtail administration of drugs that are harmful to the brain, especially the aging brain," said Dr. Khan.
"This landmark study represents a first attempt to reduce the incidence and morbidity of delirium in the postoperative patient," said thoracic surgeon Kenneth Kesler, the Harris B. Shumacker Professor of Surgery at IU School of Medicine. "Although unfortunately an overall negative study, it does move us forward by identifying both a subset of patients who may benefit from haloperidol prophylaxis and those patients who are at risk for delirium following large surgical procedures."