Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Nov 30;29(1):572.
doi: 10.1186/s40001-024-02158-y.

Effect of prophylactic perphenazine on delirium after extubation in severe acute pancreatitis

Min Chen #  1 , Meiling Yu #  1 , Dayi Zhang #  1 , Ying Chen  1 , Zhitao Yang  1 , Erzhen Chen  1 , Enqiang Mao  2 , Tongtian Ni  3
Affiliations

Effect of prophylactic perphenazine on delirium after extubation in severe acute pancreatitis

Min Chen et al. Eur J Med Res. .

Abstract

Background: Severe acute pancreatitis (SAP) is a life-threatening condition that can require invasive mechanical ventilation (IMV) to ensure adequate oxygenation and ventilation. However, IMV can cause delirium, a temporary and fluctuating state of consciousness disorder, which negatively impacts patient outcomes. Perphenazine, an antipsychotic drug that blocks dopamine receptors, can alleviate symptoms such as irritability and restlessness that caused by delirium. This retrospective study aimed to identify risk factors associated with delirium in SAP patients after extubation and withdrawal from IMV, and to determine whether prophylactic use of perphenazine could reduce the incidence of delirium.

Methods: A total of 40 patients with SAP aged 18-75 years who underwent IMV and were successfully extubated offline after treatment were included. Perphenazine was used consistently 2 mg q12 h for 2 days before extubation. The assessment of delirium began after the removal of the endotracheal tube, using Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) every 12 h. Patients were divided into delirium (n = 9) and non-delirium (n = 31) groups or perphenazine (n = 22) and non-perphenazine (n = 18) groups. The clinical data of patients upon admission and after extubation between groups were analyzed using SPSS 26 software. Binary logistic regression was used to evaluate the risk factors for delirium.

Results: Patients with a mean age of 42 years and a male to female ratio of 1.58:1 were enrolled. The incidence of delirium was 22.50%. Univariate analysis (P = 0.025) and binary logistic regression (P = 0.035, 95%CI 0.002-0.762) showed that prophylactic use of perphenazine reduced the incidence of delirium. Fentanyl use was a risk factor for delirium in the univariate analysis (P = 0.039). Patients in the delirium group were hospitalized longer than those in the non-delirium group (P < 0.05).

Conclusion: Perphenazine might have a potential effect on post-extubation delirium in SAP patients.

Keywords: Analgesia; Invasive mechanical ventilation; Prevention; Risk factor; Sedation.

PubMed Disclaimer

Conflict of interest statement

Declarations. Ethics approval and consent to participate: The Ethics Committee of Ruijin Hospital affiliated with Shanghai Jiao Tong University School of Medicine approved the study, and informed consent was waived since the data were already generated before the start of the research. Consent for publication: The authors agreed to publication in the journal. Competing interests: The authors declare no competing interests.

References

    1. Boxhoorn L, Voermans RP, Bouwense SA, Bruno MJ, Verdonk RC, Boermeester MA, van Santvoort HC, Besselink MG. Acute pancreatitis. Lancet. 2020;396(10252):726–34. - PubMed
    1. Ni T, Chen Y, Zhao B, Ma L, Yao Y, Chen E, Zhou W, Mao E. The impact of fluid resuscitation via colon on patients with severe acute pancreatitis. Sci Rep. 2021;11(1):12488. - PMC - PubMed
    1. Szatmary P, Grammatikopoulos T, Cai W, Huang W, Mukherjee R, Halloran C, Beyer G, Sutton R. Acute pancreatitis: diagnosis and treatment. Drugs. 2022;82(12):1251–76. - PMC - PubMed
    1. Pun BT, Badenes R, La Calle GH, Orun OM, Chen W, Raman R, Simpson BK, Wilson-Linville S, Hinojal Olmedillo B, de la Cueva AV, et al. Prevalence and risk factors for delirium in critically ill patients with COVID-19 (COVID-D): a multicentre cohort study. Lancet Respir Med. 2021;9(3):239–50. - PMC - PubMed
    1. Cortes-Beringola A, Vicent L, Martin-Asenjo R, Puerto E, Dominguez-Perez L, Maruri R, Moreno G, Vidan MT, Fernando A, Bueno H. Diagnosis, prevention, and management of delirium in the intensive cardiac care unit. Am Heart J. 2021;232:164–76. - PubMed

MeSH terms

LinkOut - more resources