Dexmedetomidine in contrary to haloperidol for controlling agitated delirium among spontaneously breathing non-intubated cases during the ICU stay

Background: Delirium, a common condition in ICU cases, is associated with cognitive impairment and fluctuating consciousness, contributing to higher mortality and longer hospital stays. While haloperidol has traditionally been used for treatment, its effectiveness is often limited. In contrast, dexmedetomidine (DEX), a newer sedative, has shown promise in reducing delirium duration and providing faster sedation. Evidence suggests it may be more effective than haloperidol, particularly in non-intubated cases, though more investigation is needed to confirm these findings. Aim: to determine the effect of early administration of DEX and haloperidol for the management of agitated delirium in spontaneously breathing non-intubated cases during the ICU stay. Cases and methods: In this double-blind randomized controlled investigation in Banha University Hospitals, 150 ICU cases were enrolled to investigate DEX and haloperidol efficacy in delirium and agitation management. Cases were randomized to receive DEX, haloperidol, or saline, with the primary outcomes being the attainment of a target RASS score of -3 to 0. Secondary outcomes included the occurrence of delirium, sedation requirements, safety events, and nursing care burden, with the RASS and CAM-ICU scales being used for assessment. Results: Baseline group demographics were similar. Group D had lower incidence of delirium, lower ICU and hospital stay, and fewer sedatives and analgesics utilized than Groups H and P without mortality differences. Conclusion: DEX can be an effective alternative for managing agitated delirium in non-intubated ICU cases.