Overview
This study aims to compare the effect of dexmedetomidine infusion and oral melatonin on preventing delirium in intensive care unit (ICU) patients.
Description
Delirium is experienced in 20% to 40% of the critically ill and up to 80% of mechanically ventilated (MV) medical or surgical patients . It is a confessional state that has been described as a transient global disorder of cognition, awareness, and attention and as such is not only challenging for the treating medical team, but also has a considerable impact on affected patients. It is associated with prolonged hospital length of stay and time on MV, deterioration in cognition, and increased morbidity and mortality causing additional health-care expenses.
Eligibility
Inclusion Criteria:
- Patients aged 21 years or older.
- Either gender.
- Healthy gastrointestinal function (patients tolerated oral medications by gavage or mouth).
- Richmond Agitation Sedation Scale (RASS) >-1.
- No basic delirium or mood changes before admission to intensive care unit(ICU).
Exclusion Criteria:
- Patient refusal.
- History of irreversible brain disease consistent with severe dementia.
- Patient admitted with a primary neurologic condition or injury (e.g., intracranial hemorrhage).
- Heart rate (HR) less than 50 beats/ min or second- third degree heart block in the absence of a pacemaker.
- Acute alcohol withdrawal requiring benzodiazepine administration.
- History of hepatic encephalopathy or end-stage liver disease (Child-Pugh class B or C).
- The expected duration of intensive care unit (ICU) stay less than 5 days.
- Inability to obtain informed consent.
- Pregnancy.
- Allergy to dexmedetomidine or melatonin.