Alcohol Withdrawal Syndrome in Critically Ill Patients: Identification, Assessment, and Management

Critical Care Nurse
Lynsey J Sutton, Annemarie Jutel

Abstract

Management of alcohol withdrawal in critically ill patients is a challenge. The alcohol consumption histories of intensive care patients are often incomplete, limiting identification of patients with alcohol use disorders. Abrupt cessation of alcohol places these patients at risk for alcohol withdrawal syndrome. Typically benzodiazepines are used as first-line therapy to manage alcohol withdrawal. However, if patients progress to more severe withdrawal or delirium tremens, extra adjunctive medications in addition to benzodiazepines may be required. Sedation and mechanical ventilation may also be necessary. Withdrawal assessment scales such as the Clinical Institute of Withdrawal Assessment are of limited use in these patients. Instead, general sedation-agitation scales and delirium detection tools have been used. The important facets of care are the rapid identification of at-risk patients through histories of alcohol consumption, management with combination therapies, and ongoing diligent assessment and evaluation. (Critical Care Nurse. 2016;36[1]:28-39).

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Citations

Oct 31, 2019·Journal of Clinical Pharmacology·Kaylie Love, Anthony E Zimmermann
Apr 14, 2020·Expert Opinion on Pharmacotherapy·A GlahnT Hillemacher
Sep 4, 2019·Journal of Addictions Nursing·George BensonNicola J Roberts
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Jun 19, 2021·Journal of Psychosocial Nursing and Mental Health Services·Deborah SalaniBeth King

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