Use of Dexmedetomidine in Liver Transplant Recipients With Postoperative Agitated Delirium.
OBJECTIVE
Agitated delirium has frequently occurred after liver transplantation in the intensive care unit (ICU) and sedative agents are used to treat patients. Recently, dexmedetomidine has been considered to be a promising agent for agitated delirium.


METHODS
This study took place between January 2010 and October 2012 and 42 recipients were retrospectively enrolled. Sixteen recipients were enrolled in the dexmedetomidine group and 26 recipients were placed in the haloperidol group. To compare dexmedetomidine and haloperidol, the total ICU length of stay (ICU LOS), the ICU LOS after drug administration, and the supplemental doses of sedative agents used were assessed. The endpoint was discharge from the ICU.


RESULTS
There were no significant drug-related complications in either group. Dexmedetomidine significantly decreased the ICU LOS and ICU LOS after the occurrence of delirium compared to haloperidol (13.7 days vs. 8.3 days, P = .039, 10.1 days vs. 3.1 days, P = .009). In the dexmedetomidine group, the dose of supplemental midazolam needed was lower than in the haloperidol group (1.5 mg vs. 6.85 mg, P < .001).


CONCLUSIONS
Dexmedetomidine is a promising agent for the treatment of ICU-associated agitated delirium in liver transplantation recipients.
Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
J Y
JY
Choi
Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
J M
JM
Kim
Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
C H D
CH
Kwon
Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. Electronic address: jw.joh@samsung.com.
J-W
JW
Joh
Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
S
S
Lee
Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
J B
JB
Park
Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
J S
JS
Ko
Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
M S
MS
Gwak
Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
G S
GS
Kim
Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
S J
SJ
Kim
Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
S-K
SK
Lee
D000328:Adult; D000368:Aged; D014150:Antipsychotic Agents / Q000008:administration & dosage; D003693:Delirium / Q000188:drug therapy* / Q000209:etiology; D020927:Dexmedetomidine / Q000008:administration & dosage*; D005260:Female; D006220:Haloperidol / Q000008:administration & dosage; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D007362:Intensive Care Units; D007902:Length of Stay; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008874:Midazolam / Q000008:administration & dosage; D008875:Middle Aged; D011183:Postoperative Complications; D011184:Postoperative Period; D012189:Retrospective Studies
D014150:Antipsychotic Agents; D006993:Hypnotics and Sedatives; D020927:Dexmedetomidine; D006220:Haloperidol; D008874:Midazolam