{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T17:22:58Z","timestamp":1782321778601,"version":"3.54.5"},"reference-count":41,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2013,1,17]],"date-time":"2013-01-17T00:00:00Z","timestamp":1358380800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/2.0\/"},{"start":{"date-parts":[[2013,1,17]],"date-time":"2013-01-17T00:00:00Z","timestamp":1358380800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/2.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Crit Care"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Delirium is associated with increased morbidity and mortality. We implemented a delirium prevention policy in intensive care unit (ICU) patients with a high risk of developing delirium, and evaluated if our policy resulted in quality improvement of relevant delirium outcome measures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study was a before\/after evaluation of a delirium prevention project using prophylactic treatment with haloperidol. Patients with a predicted risk for delirium of \u2265 50%, or with a history of alcohol abuse or dementia, were identified. According to the prevention protocol these patients received haloperidol 1 mg\/8 h. Evaluation was primarily focused on delirium incidence, delirium free days without coma and 28-day mortality. Results of prophylactic treatment were compared with a historical control group and a contemporary group that did not receive haloperidol prophylaxis mainly due to non-compliance to the protocol mostly during the implementation phase.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In 12 months, 177 patients received haloperidol prophylaxis. Except for sepsis, patient characteristics were comparable between the prevention and the historical (\n                      <jats:italic>n<\/jats:italic>\n                      = 299) groups. Predicted chance to develop delirium was 75 \u00b1 19% and 73 \u00b1 22%, respectively. Haloperidol prophylaxis resulted in a lower delirium incidence (65% vs. 75%,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.01), and more delirium-free-days (median 20 days (IQR 8 to 27) vs. median 13 days (3 to 27),\n                      <jats:italic>P<\/jats:italic>\n                      = 0.003) in the intervention group compared to the control group. Cox-regression analysis adjusted for sepsis showed a hazard rate of 0.80 (95% confidence interval 0.66 to 0.98) for 28-day mortality. Beneficial effects of haloperidol appeared most pronounced in the patients with the highest risk for delirium. Furthermore, haloperidol prophylaxis resulted in less ICU re-admissions (11% vs. 18%,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.03) and unplanned removal of tubes\/lines (12% vs. 19%,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.02). Haloperidol was stopped in 12 patients because of QTc-time prolongation (\n                      <jats:italic>n<\/jats:italic>\n                      = 9), renal failure (\n                      <jats:italic>n<\/jats:italic>\n                      = 1) or suspected neurological side-effects (\n                      <jats:italic>n<\/jats:italic>\n                      = 2). No other side-effects were reported. Patients who were not treated during the intervention period (\n                      <jats:italic>n<\/jats:italic>\n                      = 59) showed similar results compared to the untreated historical control group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our evaluation study suggests that prophylactic treatment with low dose haloperidol in critically ill patients with a high risk for delirium probably has beneficial effects. These results warrant confirmation in a randomized controlled trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>\n                      clinicaltrial.gov Identifier:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.clinicaltrials.gov\/ct2\/show\/NCT01187667\">NCT01187667<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/cc11933","type":"journal-article","created":{"date-parts":[[2013,1,17]],"date-time":"2013-01-17T12:26:09Z","timestamp":1358425569000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":108,"title":["Haloperidol prophylaxis in critically ill patients with a high risk for delirium"],"prefix":"10.1186","volume":"17","author":[{"given":"Mark","family":"van den Boogaard","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisette","family":"Schoonhoven","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theo","family":"van Achterberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes G","family":"van der Hoeven","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Pickkers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2013,1,17]]},"reference":[{"key":"1049_CR1","volume-title":"Diagnostic and Statistical Manual of Mental Disorders (DSM-IV)","author":"American Psychiatric Association","year":"1994","unstructured":"American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). 4th edition. 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