Please select the eligibility criteria that correspond to the clinical trial below.
Title: Patient Outcomes 6 and 12 Months After ALTA, OMEGA, EDEN and SAILS ARDS Network Trials
Brief Summary: Acute lung injury (ALI) is a severe lung condition that causes respiratory failure. The ARDS Network (ARDSNet) is a National Heart, Lung, and Blood Institute-sponsored network that is focused on improving treatments for people with ALI and a similar condition called acute respiratory distress syndrome (ARDS). This study will evaluate participants who were enrolled in one of three ARDSNet studies to examine how the treatments carried out in the prior studies affect participants' long-term health outcomes and quality of life.


Options:
A: Inclusion Criteria:

Patients will be eligible for the study if, in the opinion of the treating clinician, they continue to require mechanical ventilation only because their degree of agitation requires such a high dose of sedative medication (midazolam or propofol, the only commonly used specific sedatives in our unit) that extubation is not possible, AND in the opinion of their treating intensivist their agitation is so severe as to make lessening their sedation unsafe.

These criteria will be objectively quantified as follows:

* they have required either mechanical restraint and/or anti-delirium or sedative medication in the 4 hours prior to seeking consent AND
* their Confusion Assessment Method for the ICU (CAM-ICU) test is positive for delirium in the 4 hours prior to seeking consent AND
* their Motor Activity Assessment Scale (MAAS) score is 5 or more in the 4 hours prior to seeking consent, confirming psychomotor agitation AND
* their SOFA score is less than or equal to 5 in the 4 hours prior to seeking consent, predicting a mortality or around 5%.

Exclusion Criteria:

* Age less than 18 years old
* Pregnancy or breastfeeding
* Advanced dementia (in the premorbid state requiring professional nursing care)
* Open or closed head injury
* Death is deemed imminent and inevitable
* The patient has previously been enrolled in the DahLIA study
* Patients who could not be extubated, or who would be intubated within the following 48 hours, even if delirium or agitation were corrected. This will include:

  * Patients receiving high dose opioid for analgesia (not sedation) ( \> 40 mg/morphine/day)
  * Patients shortly to return to the operating theatre
  * Patients undergoing repeated invasive procedures, in whom it is desirable to maintain deep sedation
  * Patients likely to require ongoing airway protection or control, or ventilatory support (for example, spinal patients with an inadequate vital capacity)
* Known allergy to haloperidol or alpha 2 agonists
B: Inclusion Criteria:

* Adult patients (age 18 years or older) in a state of delirium (hyperactive ore mixed type) upon detection in the ICU (i.e., ICDSC \>3).

Exclusion Criteria:

* Hypersensitivity to the active substance
* Advanced heart block (grade 2 or 3) unless implanted pacemaker
* Uncontrolled hypotension
* Severe cardiac dysfunction
* Bradycardia
* Egg allergy
* Soybean/soy allergy
* Age below 18 years
* Terminal state
* Pregnancy
* Active psychosis (of non organic origin = functional disturbances)
* Status epilepticus or postictal states following seizures on EEG
C: Inclusion Criteria:

* Participated in the ALTA, EDEN, OMEGA, or SAILS study
* Survived until hospital discharge

Exclusion Criteria:

* Does not understand or speak English
* Has no fixed address
* Pre-existing cognitive impairment that prevents completion of the study assessments
D: Inclusion Criteria:

* 18 years of age or older
* Hospitalized on an ICU ward
* Delirium based on the RASS and the CAM-ICU assessments at any day during ICU stay
* English speaking

Exclusion Criteria:

* Admitted directly to a regular non-ICU ward
* Previously enrolled in the study
* Not eligible for delirium assessment as determined by RASS scores
* Prior history of severe mental illness
* Alcohol-related delirium
* Pregnant or nursing
* Have had an aphasic stroke

Answer: C