Effects Of Haloperidol On Delirium In Adult Patients:A Systematic Review And Meta-analysis

Objective: The aim of this systematic review and meta-analysis was to investigate whether or not the use of haloperidol could reduce the incidence of delirium in adult patients.Subjects and Methods: Pub Med,Embase,the Cochrane Library,Elsevier,Wiley,and Ovid were searched for randomized controlled trials and prospective interventional cohort studies that compared haloperidol with placebo for delirium prophylaxis or with second generation antipsychotics for delirium treatment.Complying with this requirement,Pub Med,Embase,the Cochrane Library,Elsevier,Wiley,and Ovid were searched until May 1,2017.A basic search was performed using medical subject headings and free text words:“haloperidol”,“antipsychotics”,and“delirium”.No language restriction was applied.The primary end point was the incidence and severity of delirium.Revman 5.3 was used for the data analysis.Results: After reviewing 272 relevant articles,ten studies with 1,861 patients were finally included(haloperidol versus placebo in 8 studies(n = 1734),and haloperidol versus second-generation antipsychotics in 2 studies(n = 127)).Compared with placebo,a high dose of prophylactic haloperidol(? 5 mg/d)may help reduce the incidence of delirium in adult surgical patients(risk ratio(95% confidence interval),0.50(0.32,0.79)).There were no differences in the duration of delirium,QTc interval prolongation,extrapyramidal symptoms,intensive care unit stay,hospital stay,or mortality between the haloperidol and placebo groups.For delirium treatment,haloperidol exhibited similar effects as the second-generation antipsychotics.Conclusions: In this study,the limited available data revealed that prophylaxis haloperidol at a dose of ? 5 mg/d might help reduce delirium in adult surgical patients.Further outcome studies with larger sample sizes are required to confirm these findings.