Abstract 1337: Traditional Chinese Medicine Prevent Delirium and Save the Cost in Cardiovascular Patients in the Intensive Care Unit
Background: Delirium is well known as a common and severe problem in the intensive care unit (ICU) for high cost and poor prognosis. Since delirium is a predictor of mortality, length of stay and organ dysfunction, the prevention of delirium is important in cardiovascular (CV) patients in ICU. Many preventive interventions for delirium are underlying, however, the effect for CV patient outcome remains unclear. We determined to elucidate the beneficial effects of traditional Chinese medicine (TCM) using acupuncture and Chinese herb for CV patient.
Methods: After written informed consent was obtained, we enrolled consecutive 53 patients with CV disease (heart failure, acute aortic dissection, acute coronary syndrome, and arrhythmia) entered in the ICU between January 2007 and January 2008. We assigned two group (control group (n=29): conventional intensive care, TCM group (n=24): conventional therapy plus the combination of acupuncture and Chinese herbal medicine) according to difference of the entry period. There was no significant difference Acute Physiology and Chronic Health Evaluation II (APACHE II) score and age between two groups (Control vs TCM median[IQR]: 8.0 [7.0 –13.0] vs. 10 [7.3–15.5] points, and 67 [59 –55] vs. 75 [56 – 80] year-old). Patients in TCM group were administrated orally Kamikihito (for the improvement of memory and recognition) three times a day as a Chinese herbal formula, and were received acupuncture treatment once a day during ICU stay according to TCM theory. We performed the Confusion Assessment Method for the ICU (CAM-ICU) to evaluate delirium at days 1, 3 and 6 through ICU staying.
Results: Patients who developed delirium were thirteen of fifty-three (24.5%) independent of CV disease. There was no significant difference the length of ICU stay between two groups (4.0 [2.5– 8.0] vs. 4.5 [3– 6.75] days). However the incidence rate of delirium in TCM group (8.3%) was significantly lower than control group (37.9%) (p<0.05). Moreover sedative drugs against aggressive state were used in TCM group less than in control group.
Conclusions: TCM prevent the incidence of delirium in CV disease patients in ICU. TCM may be good preventive and alternative therapy addition of conventional therapy for CV patient in ICU to save the cost during ICU stay.