Combined therapy with dexmedetomidine and quetiapine in patients with myocardial infarction complicated by delirium

Vitik A.A.; Shen N.P.

doi:https://doi.org/10.17116/anaesthesiology202401141

Vitik A.A.

Tyumen State Medical University;
Tyumen Regional Clinical Hospital No. 1

ORCID: 0000-0002-0585-3489

Shen N.P.

Tyumen State Medical University;
Tyumen Regional Clinical Hospital No. 1

ORCID: 0000-0002-3256-0374

Combined therapy with dexmedetomidine and quetiapine in patients with myocardial infarction complicated by delirium

Authors:

Vitik A.A., Shen N.P.

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Journal: Russian Journal of Anesthesiology and Reanimatology. 2024;(1): 41‑45

DOI: 10.17116/anaesthesiology202401141

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To cite this article:

Vitik AA, Shen NP. Combined therapy with dexmedetomidine and quetiapine in patients with myocardial infarction complicated by delirium. Russian Journal of Anesthesiology and Reanimatology. 2024;(1):41‑45. (In Russ.)
https://doi.org/10.17116/anaesthesiology202401141

Использование инфографики авторами научных работ

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OBJECTIVE

To compare therapy with dexmedetomidine and its combination with quetiapine in patients with acute myocardial infarction complicated by delirium.

MATERIAL AND METHODS

A prospective cohort randomized study included 43 patients with myocardial infarction complicated by delirium. Patients were randomized into two groups: the 1st group — sedation and treatment of delirium with dexmedetomidine; the 2nd group — combination of dexmedetomidine with quetiapine. Otherwise, treatment and diagnosis were similar. Mental status of patients was assessed using the BPRS and MMSE scales upon discharge from ICU and hospital.

RESULTS

Duration of delirium was similar (51±13.5 and 49±12.8 hours, respectively, p=0.73). Patients of the 2nd group required significantly lower doses of dexmedetomidine (0.4±0.2 μg/kg/h) for the same RASS value, than patients of the 1st group (0.8±0.2 μg/kg/h) (p=0.04). We analyzed the effectiveness of combined therapy considering BPRS and MMSE scores at discharge from ICU and hospital. Effectiveness was high. The BPRS score was significantly lower in the 2nd group (30 (28; 32) and 42 (39; 48) scores (p=0.001) at discharge from ICU; 24 (20; 26) and 35 (30; 38) scores (p=0.001) at discharge from hospital). Cognitive status of patients was similar according to the MMSE scale.

CONCLUSION

We observed high efficacy of combination of dexmedetomidine and quetiapine for delirium. Duration of delirium was equal in both groups, but lower doses of dexmedetomidine were required to achieve target sedation in the main group. There was a positive dynamics in mental status. We observed no significant effect of combined therapy on hemodynamics, respiratory and cognitive functions.

Keywords:

delirium

myocardial infarction

dexmedetomidine

quetiapine

Authors:

Vitik A.A.

Tyumen State Medical University;
Tyumen Regional Clinical Hospital No. 1

ORCID: 0000-0002-0585-3489

Shen N.P.

Tyumen State Medical University;
Tyumen Regional Clinical Hospital No. 1

ORCID: 0000-0002-3256-0374

Received:

07.07.2023

Accepted:

12.10.2023

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