Haloperidol serum concentrations in critically ill patients included in the REDUCE study
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LETTER
Haloperidol serum concentrations in critically ill patients included in the REDUCE study Anne W. van Schijndel1, Eric J. F. Franssen2, Peter Pickkers3, Saskia Rijkenberg1, Mark van den Boogaard3 and Peter H. J. van der Voort1* © 2018 Springer-Verlag GmbH Germany, part of Springer Nature and ESICM
Dear Editor,
Introduction ICU delirium occurs frequently and is associated with unfavorable outcome. A recent delirium prevention study, the REDUCE study, has assessed the efficacy of prophylactic use of haloperidol [1]. This study showed no effect for any group for any outcome [1]. It is unknown if serum levels of haloperidol are related to the effect of haloperidol in prevention or treatment of ICU-acquired delirium. Therapeutic serum levels of haloperidol for treatment of schizophrenia are reported to be 3–20 µg/L [2, 3]. We pre-planned to determine haloperidol serum concentrations in ICU patients receiving prophylactic haloperidol in the REDUCE study. Methods and results We included consecutive patients participating in the REDUCE study in one particular ICU. Haloperidol 3 × 1 mg and 3 × 2 mg daily and a placebo group were compared. A blood sample was drawn immediately before the third dose of study medication. This haloperidol trough serum level was assessed by a liquid chromatography method combined with mass spectroscopy (LC–MS/MS). Calibration curves were constructed by
*Correspondence: [email protected] 1 Department of Intensive Care, OLVG Hospital, 95500, 1090 Amsterdam, The Netherlands Full author information is available at the end of the article
adding known amounts of haloperidol to blank human serum (1–40 μg/L). All results were blinded until the REDUCE study was ended. Non-parametric tests were used (Kruskal–Wallis, Mann–Whitney U, or chi-square where appropriate) to test between groups. Two-sided p
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