Implementation of a Protocol Using the 5-Item Brief Alcohol Withdrawal Scale for Treatment of Severe Alcohol Withdrawal in Intensive Care Units
| Autor: | Edward S. Chen, Darius A. Rastegar, Andrew S. Jarrell |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Protocol (science)
medicine.medical_specialty business.industry 030208 emergency & critical care medicine Alcohol Length of Stay Alcohol withdrawal scale Critical Care and Intensive Care Medicine Substance Withdrawal Syndrome Alcoholism Benzodiazepines Intensive Care Units 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine chemistry Intensive care Emergency medicine Humans Hypnotics and Sedatives Medicine 030212 general & internal medicine business Retrospective Studies |
| Zdroj: | Journal of Intensive Care Medicine. 36:1361-1365 |
| ISSN: | 1525-1489 0885-0666 |
| DOI: | 10.1177/0885066620952762 |
| Popis: | Background: There is variation in the treatment of patients with severe alcohol withdrawal and a need for effective protocols. The purpose of this study was to evaluate the implementation of a symptom-triggered benzodiazepine protocol using the 5-item Brief Alcohol Withdrawal Scale (BAWS) for treatment of alcohol withdrawal in intensive care units (ICUs). Methods: This retrospective study included admissions to ICUs of 2 hospitals over 6 months who had an alcohol withdrawal protocol ordered and experienced severe withdrawal. Records were reviewed to collect demographic data, benzodiazepine exposure, duration of treatment, and withdrawal severity. Results: The protocol was ordered and implemented in 279 admissions; 48 (17.9%) had severe withdrawal defined as a BAWS of 6 or more. The majority of the 48 patients were from the emergency department (79.2%); mean hospital length of stay was 11.2 days and mean ICU stay 6.6 days; 31.3% required mechanical ventilation. A little more than half were treated only with the protocol (53.2%); 25.0% received additional benzodiazepines, 20.8% dexmedetomidine, 10.4% propofol, 25.0% antipsychotics and 2.0% phenobarbital. Conclusion: Among ICU patients treated for alcohol withdrawal with a symptom-triggered benzodiazepine protocol using a novel 5-item scale, most did not develop severe withdrawal, and of those who did, approximately half were treated with the protocol alone. |
| Databáze: | OpenAIRE |
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