title: Outcome of nicotine replacement therapy in patients admitted to ICU: a randomized controlled double-blind prospective pilot study.
abstract: BACKGROUND
  The effect of nicotine withdrawal in smokers admitted to the ICU is not well understood, so the role of nicotine replacement therapy (NRT) in those patients is controversial.
  
  
  OBJECTIVE
  To determine whether NRT in ICU patients affects the need for sedatives/analgesics, ventilator days, and ICU stay.
  
  
  METHODS
  In a 20-bed ICU, 40 subjects were randomized to either a 21 mg nicotine patch or a placebo nicotine patch daily until either ICU discharge, transfer to a medical floor, or 10 weeks in the ICU. We collected data on sedatives/analgesics use during ICU stay and use and duration of mechanical ventilation .
  
  
  RESULTS
  There were 27 male and 13 female subjects. The mean age was 57.4 y in the intervention group and 52.5 y in the control group. The mean Acute Physiology and Chronic Health Evaluation II score was 14.3 in the intervention group and 13.8 in the control group. The mean ICU stay was 4.5 d in the intervention group and 7 d in the control group. The mean number of days on ventilator was 1.9 in the intervention group and 3.5 in the control group. The number of days on sedation/analgesia was less in the intervention group than in the control group.
  
  
  CONCLUSIONS
  Although ICU stay and ventilator days decreased numerically in this pilot study, statistically there was no beneficial effect from NRT. (International Standard Randomised Controlled Trial Register ISRCTN66928309).
authors.affiliation: Department of Internal Medicine, St Barnabas Hospital, Bronx, New York.
authors.forename: Vikas
authors.initials: V
authors.lastname: Pathak
authors.forename: Iliana Samara Hurtado
authors.initials: IS
authors.lastname: Rendon
authors.forename: Roxana
authors.initials: R
authors.lastname: Lupu
authors.forename: Nancy
authors.initials: N
authors.lastname: Tactuk
authors.forename: Toyosi
authors.initials: T
authors.lastname: Olutade
authors.forename: Carolyn
authors.initials: C
authors.lastname: Durham
authors.forename: Richard
authors.initials: R
authors.lastname: Stumacher
mesh_terms: D000328:Adult; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D013997:Time Factors; D061485:Tobacco Use Cessation Devices; D014029:Tobacco Use Disorder / Q000628:therapy*; D016896:Treatment Outcome; D055815:Young Adult
keywords: ICU; nicotine addiction; nicotine replacement therapy; smoking status