Chlorpromazine as Treatment for Refractory Agitation Associated with Pediatric Delirium.
JournalThe journal of pediatric pharmacology and therapeutics : JPPT
MetadataShow full item record
AbstractObjective: Delirium and agitation can be devastating and prolong the length of hospitalization. As part of our continuous improvement efforts, we implemented the use of intermittent chlorpromazine therapy to target refractory agitation associated with hyperactive or mixed delirium (RAA-D). The purpose of this study was to evaluate the effectiveness of chlorpromazine on RAA-D and delirium symptoms as well as any adverse effects in critically ill children. Methods: Retrospective chart review was conducted for children admitted to the pediatric intensive care unit who were treated with chlorpromazine for RAA-D from March 2017 to January 2019. The primary end point was to determine differences in Cornell Assessment for Pediatric Delirium (CAPD) and State Behavioral Scale (SBS) scores 24 hours before and after chlorpromazine administration. The secondary end points were the 24-hour cumulative dosing of narcotic and sedative agents before and after chlorpromazine administration and adverse events associated with chlorpromazine use. Results: Twenty-six patients were treated with chlorpromazine for RAA-D; 16 (61.5%) were male with a median age of 14.5 months (IQR, 6-48). The mean CAPD (n = 24) and median SBS (n = 23) scores were significantly lower 24 hours after chlorpromazine use when compared to baseline scores, 12 vs 8.9 (p = 0.0021) and 1 vs -1, (p = 0.0005) respectively. No significant adverse effects were observed. Conclusions: Chlorpromazine use in critically ill children with RAA-D was helpful for managing symptoms without adverse events. Further investigation is needed to evaluate the use of chlorpromazine to treat RAA-D to avoid long-term use of an antipsychotic.
Rights/TermsCopyright. Pediatric Pharmacy Association. All rights reserved. For permissions, email email@example.com 2022.
Identifier to cite or link to this itemhttp://hdl.handle.net/10713/20251
- Drug therapy for delirium in terminally ill adults.
- Authors: Finucane AM, Jones L, Leurent B, Sampson EL, Stone P, Tookman A, Candy B
- Issue date: 2020 Jan 21
- Safety and Effectiveness of Intravenous Chlorpromazine for Agitation in Critically Ill Patients.
- Authors: Choi M, Barra ME, Newman K, Sin JH
- Issue date: 2020 Oct
- Delirium and Developmental Disability: Improving Specificity of a Pediatric Delirium Screen.
- Authors: Kaur S, Silver G, Samuels S, Rosen AH, Weiss M, Mauer EA, Gerber LM, Greenwald BM, Traube C
- Issue date: 2020 May
- Factors Associated with the Effectiveness of Intravenous Administration of Chlorpromazine for Delirium in Patients with Terminal Cancer.
- Authors: Hasuo H, Kanbara K, Fujii R, Uchitani K, Sakuma H, Fukunaga M
- Issue date: 2018 Sep
- Changes in Sedation Practices in Association with Delirium Screening in Infants After Cardiopulmonary Bypass.
- Authors: Chomat MR, Said AS, Mann JL, Wallendorf M, Bickhaus A, Figueroa M
- Issue date: 2021 Aug