Dexmedetomidine for Nonventilated Patients with Delirium

IV Haloperidol 2.5-5mg every 10-30minutes until RASS 0 to -2 or max dose of 30mg

 

Haloperidol responders:

  • haldol infusion 0.5-1mg/hr titrate to RASS of 0

 

Haloperidol nonresponders:

  • continue Haldol infusion (0.5-1mg/hr)
  • start dexmedetomidine without loading dose at 0.2 ug/kg/hr and titrate to RASS of 0 to max of 0.7 ug/kg/min
  • once RASS = 0 on both drips, gradually taper and discontinue haldol

 

 

Reference:

Carrasco, Genís et al. “Dexmedetomidine For The Treatment Of Hyperactive Delirium Refractory To Haloperidol In Nonintubated ICU Patients”. Critical Care Medicine 44.7 (2016): 1295-1306.

 

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