当前位置： SCI文献检索 > JOURNAL OF INTENSIVE CARE MEDICINE期刊下所有文献 > Safety and Effectiveness of Intravenous Chlorpromazine for Agitation in Critically Ill Patients.

Safety and Effectiveness of Intravenous Chlorpromazine for Agitation in Critically Ill Patients.

Abstract：

BACKGROUND:Agitation is common in the intensive care unit (ICU). Although antipsychotics are frequently used as first-line therapy, chlorpromazine has fallen out of favor due to risk of cardiovascular complications and severe hypotension. Although chlorpromazine is used anecdotally, there is a lack of data regarding its safety and effectiveness. The objective of this study was to investigate the use of intravenous (IV) chlorpromazine for agitation in the ICU setting. METHODS:A retrospective review was performed at a tertiary care academic medical center. Patients were included if they received IV chlorpromazine in the ICU for agitation, infused at a rate of 1 mg/min. Primary end points were change in systolic blood pressure (SBP), heart rate (HR), and mean arterial pressure (MAP) within 4 hours of administration. Secondary end points included change in vasopressor and adjunct sedative medication requirements, achievement of Richmond-Agitation Sedation Scale (RASS) 0 to -1, and incidence of cardiac arrhythmias. RESULTS:A total of 39 patients encompassing 107 IV chlorpromazine administrations were included. The median dose was 25 mg. Median vital signs prior to infusion were SBP 129 mm Hg, HR 90 beats/minute, and MAP 88 mm Hg. Over the subsequent 4 hours, SBP and HR did not change significantly (P = .83 and P = .10, respectively). Mean arterial pressure decreased from a median of 88 to 83 mm Hg (P = .04). There were no significant changes in vasopressor requirements, adjunct sedative medication requirements, or achievement of RASS goal. No patients developed symptomatic cardiac arrhythmias. CONCLUSION:In our small retrospective study, the use of IV chlorpromazine at routine doses did not result in clinically significant hemodynamic changes when infused at a rate of 1 mg/min. Intravenous chlorpromazine may be considered as a potential treatment option for agitation in ICU patients with appropriate monitoring.

journal_name

J Intensive Care Med

journal_title

Journal of intensive care medicine

authors

Choi M,Barra ME,Newman K,Sin JH

doi

10.1177/0885066618818787

subject

Has Abstract

pub_date

2020-10-01 00:00:00

pages

1118-1122

issue

eissn

0885-0666

issn

1525-1489

journal_volume

pub_type

杂志文章

在线工具

Safety and Effectiveness of Intravenous Chlorpromazine for Agitation in Critically Ill Patients.