Frequency, Severity, and Treatment of Agitation in Young versus Elderly Patients in the ICU
- 17 January 2000
- journal article
- research article
- Published by Wiley in Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy
- Vol. 20 (1), 75-82
- https://doi.org/10.1592/phco.20.1.75.34663
Abstract
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.Keywords
This publication has 36 references indexed in Scilit:
- Analgesia, Sedation, and Therapeutic Paralysis in the Critically IllSeminars in Respiratory and Critical Care Medicine, 1997
- Lorazepam and midazolam in the intensive care unitCritical Care Medicine, 1996
- Practice parameters for intravenous analgesia and sedation for adult patients in the intensive care unitCritical Care Medicine, 1995
- Propofol versus midazolam for intensive care unit sedation after coronary artery bypass graftingCritical Care Medicine, 1994
- Continuous intravenous infusions of lorazepam versus midazolam for sedation during mechanical ventilatory supportCritical Care Medicine, 1994
- Patterns of prescribing and administering drugs for agitation and pain in patients in a surgical intensive care unitCritical Care Medicine, 1994
- Beyond the Ramsay scaleCritical Care Medicine, 1994
- Continuous infusion of haloperidol controls agitation in critically ill patientsCritical Care Medicine, 1994
- Management of Drug Therapy in the ElderlyNew England Journal of Medicine, 1989
- Analytic Reviews : Rapid Tranquilization of the Agitated Intensive Care Unit PatientJournal of Intensive Care Medicine, 1988