Premium
Frequency, Severity, and Treatment of Agitation in Young versus Elderly Patients in the ICU
Author(s) -
Fraser Gilles L.,
Prato B. Stephen,
Riker Richard R.,
Berthiaume Donald,
Wilkins Micheline L.
Publication year - 2000
Publication title -
pharmacotherapy: the journal of human pharmacology and drug therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.227
H-Index - 109
eISSN - 1875-9114
pISSN - 0277-0008
DOI - 10.1592/phco.20.1.75.34663
Subject(s) - medicine , lorazepam , haloperidol , intensive care unit , midazolam , dose , dosing , anesthesia , population , prospective cohort study , cohort , delirium , emergency medicine , intensive care medicine , environmental health , sedation , dopamine
Study Objective. To study the frequency, duration, severity, and treatment of agitation in patients in the intensive care unit (ICU) to determine if the elderly represent a distinct population. Design. Prospective cohort study. Setting. Tertiary care, 10‐bed, multidisciplinary ICU. Patients. All patients older than 18 years of age admitted for longer than 24 hours during a 4‐month period. Interventions. None. Measurements and Main Results. One hundred thirty patients were studied for 916 patient‐days; 63 (48%) were elderly (> 65 yrs). Nurses and physicians described agitated behavior in 92 patients (70.8%) during 534 (58.3%) patient‐days, and it was severe or dangerous in 60 patients (46.1%) during 273 (30%) patient‐days. There were no age‐related differences in frequency, severity, and duration of agitation. Opiates, benzodiazepines, and haloperidol were administered during 72%, 62%, and 29% of agitated patient‐days, respectively. Haloperidol was administered more often to elderly patients (p=0.015); otherwise no between‐group differences were noted. Daily dosing requirements were less in the elderly for intermittent intravenous lorazepam, haloperidol, and morphine but not for midazolam (p=0.15). When these dosages were corrected for body mass, no statistical differences between young and old were found. Conclusion. In the ICU, the elderly are not a distinct population for agitation.