General Critical Care

This secondary analysis of a randomized clinical trial involving 566 ICU patients with delirium and baseline QTc intervals less than 550 ms investigated the effects of antipsychotics on QTc intervals and the risk of fatal arrhythmias. The study found that neither haloperidol nor ziprasidone significantly increased the QTc intervals compared to placebo. Furthermore, there were no fatal cardiac arrhythmias related to the study drugs. These findings suggest that in ICU patients with delirium and a QTc interval under 550 ms, the use of these antipsychotics may not lead to clinically significant cardiac arrhythmias.

The findings of this trial suggest that daily QTc interval monitoring during antipsychotic use may have limited value in patients in the ICU with normal baseline QTc and few risk factors for QTc prolongation.

Antipsychotics and the QTc Interval During Delirium in the Intensive Care Unit: A Secondary Analysis of a Randomized Clinical Trial | Critical Care…

In a multi-center, double-blind randomized trial across eight Dutch ICUs, 132 critically ill adults with delirium were administered intravenous haloperidol or placebo, resulting in no significant difference in delirium- and coma-free days. The study, which was terminated early for futility, also found haloperidol might decrease the need for benzodiazepines and reduce agitation-related behaviors, although these secondary outcomes were not statistically conclusive.

Efficacy of haloperidol to decrease the burden of delirium in adult critically ill patients: the EuRIDICE randomized clinical trial | Critical Care | Full Text (biomedcentral.com)