The efficacy and safety of haloperidol for the treatment of delirium in critically ill patients: a systematic review and meta-analysis of randomized controlled trials

Jian Huang; Hui Zheng; Xianfeng Zhu; Kai Zhang; Xiaofeng Ping

doi:10.3389/fmed.2023.1200314

The efficacy and safety of haloperidol for the treatment of delirium in critically ill patients: a systematic review and meta-analysis of randomized controlled trials

Front Med (Lausanne). 2023 Jul 27:10:1200314. doi: 10.3389/fmed.2023.1200314. eCollection 2023.

Authors

Jian Huang¹, Hui Zheng², Xianfeng Zhu¹, Kai Zhang³, Xiaofeng Ping¹

Affiliations

¹ Department of Critical Care Medicine, Hangzhou Ninth People's Hospital, Hangzhou, China.
² Department of Emergency Medicine, Hangzhou Ninth People's Hospital, Hangzhou, China.
³ Department of Critical Care Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.

Abstract

Purpose: Delirium is common during critical illness and is associated with poor outcomes. Therefore, we conducted this meta-analysis to investigate the efficacy and safety of haloperidol for the treatment of delirium in critically ill patients.

Methods: Randomized controlled trials enrolling critically ill adult patients to compare haloperidol with placebo were searched from inception through to February 20th, 2023. The primary outcome were delirium-free days and overall mortality, secondary outcomes were length of intensive care unit stay, length of hospital stay, and adverse events.

Results: Nine trials were included in our meta-analysis, with a total of 3,916 critically ill patients. Overall, the pooled analyses showed no significant difference between critically ill patients treated with haloperidol and placebo for the delirium-free days (MD -0.01, 95%CI -0.36 to 0.34, p = 0.95, I² = 30%), overall mortality (OR 0.89, 95%CI 0.76 to 1.04, p = 0.14, I² = 0%), length of intensive care unit stay (MD -0.06, 95%CI -0.16 to 0.03, p = 0.19, I² = 0%), length of hospital stay (MD -0.06, 95%CI -0.61 to 0.49, p = 0.83, I² = 0%), and adverse events (OR 0.90, 95%CI 0.60 to 1.37, p = 0.63, I² = 0%).

Conclusion: Among critically ill patients, the use of haloperidol as compared to placebo has no significant effect on delirium-free days, overall mortality, length of intensive care unit and/or hospital stay. Moreover, the use of haloperidol did not increase the risk of adverse events.

Keywords: ICU; critically ill adult patients; delirium; haloperidol; meta-analysis.