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It has taken me quite a while to find the information about Haldol and cytokine storms.

This is the website:

http://72.14.207.104/search?q=cache:M6lrcPV_mV4J:www.medscape.com/viewarticle/491457+cytokine+storm+treatment&hl=en

Here is the article, so it isn't lost forever:

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Haloperidol Improves Survival in Mechanically Ventilated, Critically Ill Patients

Yael Waknine

Oct. 15, 2004 — Early use of haloperidol in critically ill patients undergoing mechanical ventilation is associated with significantly reduced hospital mortality, according to the results of a preliminary retrospective cohort study presented at the 17th annual congress of the European Society of Intensive Care Medicine (ESICM) in Berlin, Germany. The paper has also been accepted for publication in Critical Care Medicine.

"Haloperidol has been used for many years to manage agitation in mechanically ventilated intensive care unit (ICU) patients, and it is the recommended drug for treatment of delirium in the ICU," Eric B. Milbrandt, MD, MPH, assistant professor of critical care medicine at the University of Pittsburgh School of Medicine in Pennsylvania, told Medscape in a phone interview. "In addition to reducing agitation and delirium, haloperidol inhibits secretion of pro-inflammatory cytokines and improves survival in an experimental model of sepsis in rats."

To determine whether early treatment with haloperidol would improve survival, the investigators reviewed the records of 1,095 ICU patients during the past year that were mechanically ventilated for a period of longer than 48 hours.

Patients were classified on the basis of whether they had received haloperidol within two days of mechanical ventilation initiation (n = 83) or no haloperidol at all (control subjects, n = 906), on the hypothesis that treatment must be initiated early in the course of mechanical ventilation to affect outcome. Patients administered haloperidol received a mean dose of 11.5 (± 11.6) mg/day for a mean period of 3.5 (± 4.6) days.

The two groups were similar in all respects with the exception of sex — the haloperidol group consisted of a greater proportion of men compared with the control group (67.5% vs 55.2%; P = .03).

The results showed that treatment with haloperidol was associated with significantly lower patient mortality (20.5% vs 36.1%; P = .004) compared with control subjects. An inverse relationship was found between mortality and increasing mean daily haloperidol dose (no haloperidol: 36.1%, 0.5 - 5.0 mg/day: 36.1%, 5.1 - 12.5 mg/day: 15.4%, more than 12.5 mg/day: 7.7%; P for trend = .001).

Logistic and Cox regression analyses showed haloperidol use to be associated with a significantly lower risk of hospital mortality (odds ratio [OR], 0.35; 95% confidence interval [CI], 0.18 - 0.69; P = .0022), and decreased death rate (hazard ratio, 0.39; 95% CI, 0.30 - 0.50; P = .0002) compared with control subjects, even after adjustments for age, comorbidities, race, admission type and diagnosis, ICU type, Simplified Acute Physiology (SAPS) II score, and Sepsis Related Organ Failure (SOFA) score.

Absence of haloperidol therapy was associated with a significantly higher risk of mortality (OR, 2.26; 95% CI, 1.25 - 4.05; P = .006) compared with those administered haloperidol.

"Treatment with haloperidol might avoid excess sedative and analgesic use, which has been associated with prolonged mechanical ventilation and ICU length of stay in other studies," suggested Dr. Milbrandt in explaining the study outcomes, adding that stabilization of cognitive function with haloperidol may have also reduced or reversed the negative effects of central nervous system–mediated anti-inflammatory mechanisms and interrupted central-peripheral signaling that are associated with the pathogenesis of severe illness.

"Haloperidol has anti-inflammatory effects on cytokines," Dr. Milbrandt noted. "Given these effects, treatment with haloperidol may have reduced the cytokine storm associated with critical illness, thereby reducing multi-organ dysfunction and improving survival."

Limitations of the study include its retrospective nature and possible indication bias despite adjustment for potential confounders. "Haloperidol patients may have been agitated but cognitively intact — and therefore healthier, or haloperidol patients may have been delirious and therefore sicker," Dr. Milbrandt observed.

"Treatment with haloperidol during mechanical ventilation was associated with significantly lower hospital mortality for mechanically ventilated ICU patients," Dr. Milbrandt concluded, adding, "Because of the observational nature of this study and the potential risks associated with haloperidol use, these findings should be confirmed in a prospective randomized placebo-controlled trial before being applied to routine patient care."

ESICM 17th Annual Congress: Abstract 251. Presented Oct. 11, 2004.

Reviewed by Gary D. Vogin, MD

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I have a real concern that this very valuable and potentially lifesaving information may be lost or not known about, so I posted the entire article here.

I am not at home, so, somebody please put this on their computer and save it, and let me know, okay? Thanks very much.