title: Use of dexmedetomidine for the treatment of alcohol withdrawal syndrome in critically ill patients: a retrospective case series.
abstract: Alcohol withdrawal syndrome (AWS) continues to be a challenge to manage in the ICU setting, and the ideal pharmacological treatment continues to evolve. Dexmedetomidine is a newer agent approved for short-term sedation in the ICU, but its use in the treatment of AWS has been limited. We report a retrospective case series of ten patients who were identified as receiving dexmedetomidine for AWS as designated by electronic pharmacy records. All subjects were male, with a mean age of 53.6 years, and a mean ICU length of stay of 9.3 days. They were all diagnosed with AWS by DSM-IV criteria. All the study patients received dexmedetomidine during their hospital course as a treatment for AWS. Studied variables included demographic data, dose and duration of dexmedetomidine, other pharmaceutical agents, and hemodynamics. Dexmedetomidine was safe to use in all patients, although mechanical ventilation was still required in three patients. With dexmedetomidine, the autonomic hyperactivity was blunted, with a mean 12.8% reduction in rate pressure product observed. Consideration should be given to the combined use of dexmedetomidine with benzodiazepines in the treatment of AWS.
authors.affiliation: Division of Trauma and Critical Care, Department of Surgery, Winthrop University Hospital, 259 First Street, Mineola, NY 11501, USA. jdemuro@winthrop.org
authors.forename: Jonas P
authors.initials: JP
authors.lastname: DeMuro
authors.forename: David G
authors.initials: DG
authors.lastname: Botros
authors.forename: Ela
authors.initials: E
authors.lastname: Wirkowski
authors.forename: Adel F
authors.initials: AF
authors.lastname: Hanna
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000430:Alcohol Withdrawal Delirium / Q000188:drug therapy*; D014150:Antipsychotic Agents / Q000627:therapeutic use; D001569:Benzodiazepines; D002492:Central Nervous System Depressants / Q000097:blood; D003422:Critical Care; D016638:Critical Illness; D020927:Dexmedetomidine / Q000009:adverse effects / Q000627:therapeutic use*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004359:Drug Therapy, Combination; D000431:Ethanol / Q000097:blood; D006220:Haloperidol / Q000627:therapeutic use; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents; D002492:Central Nervous System Depressants; D006993:Hypnotics and Sedatives; D001569:Benzodiazepines; D000431:Ethanol; D020927:Dexmedetomidine; D006220:Haloperidol