Improving delirium care in the intensive care unit

The design of a pragmatic study

Noll L. Campbell, Babar Khan, Mark Farber, Tiffany Campbell, Anthony J. Perkins, Siu Hui, Greg Abernathy, John Buckley, Regg Sing, Jason Tricker, Mohammad Zawahiri, Malaz Boustani

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Background: Delirium prevalence in the intensive care unit (ICU) is high. Numerous psychotropic agents are used to manage delirium in the ICU with limited data regarding their efficacy or harms.Methods/Design: This is a randomized controlled trial of 428 patients aged 18 and older suffering from delirium and admitted to the ICU of Wishard Memorial Hospital in Indianapolis. Subjects assigned to the intervention group will receive a multicomponent pharmacological management protocol for delirium (PMD) and those assigned to the control group will receive no change in their usual ICU care. The primary outcomes of the trial are (1) delirium severity as measured by the Delirium Rating Scale revised-98 (DRS-R-98) and (2) delirium duration as determined by the Confusion Assessment Method for the ICU (CAM-ICU). The PMD protocol targets the three neurotransmitter systems thought to be compromised in delirious patients: dopamine, acetylcholine, and gamma-aminobutyric acid. The PMD protocol will target the reduction of anticholinergic medications and benzodiazepines, and introduce a low-dose of haloperidol at 0.5-1 mg for 7 days. The protocol will be delivered by a combination of computer (artificial intelligence) and pharmacist (human intelligence) decision support system to increase adherence to the PMD protocol.Discussion: The proposed study will evaluate the content and the delivery process of a multicomponent pharmacological management program for delirium in the ICU.Trial Registration: ClinicalTrials.gov: NCT00842608.

Original languageEnglish
Article number139
JournalTrials
Volume12
DOIs
StatePublished - Jun 6 2011

Fingerprint

Delirium
Intensive Care Units
Pharmacology
Confusion
Artificial Intelligence
Cholinergic Antagonists
Haloperidol
Benzodiazepines
Intelligence
Psychological Stress
Pharmacists
gamma-Aminobutyric Acid
Acetylcholine
Neurotransmitter Agents
Dopamine
Randomized Controlled Trials

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Pharmacology (medical)

Cite this

Improving delirium care in the intensive care unit : The design of a pragmatic study. / Campbell, Noll L.; Khan, Babar; Farber, Mark; Campbell, Tiffany; Perkins, Anthony J.; Hui, Siu; Abernathy, Greg; Buckley, John; Sing, Regg; Tricker, Jason; Zawahiri, Mohammad; Boustani, Malaz.

In: Trials, Vol. 12, 139, 06.06.2011.

Research output: Contribution to journalArticle

Campbell, NL, Khan, B, Farber, M, Campbell, T, Perkins, AJ, Hui, S, Abernathy, G, Buckley, J, Sing, R, Tricker, J, Zawahiri, M & Boustani, M 2011, 'Improving delirium care in the intensive care unit: The design of a pragmatic study', Trials, vol. 12, 139. https://doi.org/10.1186/1745-6215-12-139
Campbell, Noll L. ; Khan, Babar ; Farber, Mark ; Campbell, Tiffany ; Perkins, Anthony J. ; Hui, Siu ; Abernathy, Greg ; Buckley, John ; Sing, Regg ; Tricker, Jason ; Zawahiri, Mohammad ; Boustani, Malaz. / Improving delirium care in the intensive care unit : The design of a pragmatic study. In: Trials. 2011 ; Vol. 12.
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