title: Use of propofol infusion in alcohol withdrawal-induced refractory delirium tremens.
abstract: BACKGROUND
  Delirium tremens is a potentially fatal complication of alcohol withdrawal. In severe delirium, very large dosages of benzodiazepines can be required and in refractory cases, sedation with propofol can be used. Treatment of refractory delirium tremens with propofol is mainly described in case reports. We aimed to evaluate the treatment of delirium tremens with propofol infusion for 48 h.
  
  
  METHODS
  This study was a single-centre retrospective cohort analysis of 15 patient journals covering the period from May 2012 to September 2013.
  
  
  RESULTS
  Five women and ten men were included. Their mean age was 50.9 years. Prior to propofol treatment, conventional treatment with up to 1,500 mg of benzodiazepines, 2,000 mg of chlordiazepoxide or 1,200 mg of phenobarbital was attempted in the medical or psychiatric ward, without effect (sleep). Patients were sedated, intubated and mechanically ventilated in the intensive care unit. The mean propofol infusion rate was 4.22 mg/kg/h. Thirteen patients received supplemental infusion of opioids, whereas seven required concomitant vasopressor infusion. Once propofol infusion was discontinued after 48 h, 12 patients had a long awakening, displaying symptoms of prolonged sedation. Twelve of the 15 patients treated for delirium tremens with propofol for 48 h were successfully treated. Three patients needed further treatment.
  
  
  CONCLUSIONS
  Our study suggests that treatment with propofol is viable. Establishing indication, dose, duration, and long-term effects of propofol treatment of delirium tremens requires further investigation.
  
  
  BACKGROUND
  not relevant.
  
  
  BACKGROUND
  not relevant.
authors.affiliation: Anæstesiologisk Afdeling Y, Glostrup Hospital, Nordre Ringvej 29-67, 2600 Glostrup, Denmark. kristian.l@dadlnet.dk.
authors.forename: Kristian
authors.initials: K
authors.lastname: Lorentzen
authors.forename: Anne Øberg
authors.initials: AØ
authors.lastname: Lauritsen
authors.forename: Asger Ole
authors.initials: AO
authors.lastname: Bendtsen
mesh_terms: D000328:Adult; D000368:Aged; D000430:Alcohol Withdrawal Delirium / Q000188:drug therapy*; D000701:Analgesics, Opioid / Q000008:administration & dosage; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000627:therapeutic use*; D007262:Infusions, Intravenous; D007442:Intubation, Intratracheal; D008297:Male; D008875:Middle Aged; D009638:Norepinephrine / Q000008:administration & dosage; D015742:Propofol / Q000008:administration & dosage / Q000627:therapeutic use*; D019233:Retreatment; D012189:Retrospective Studies
chemical_list: D000701:Analgesics, Opioid; D006993:Hypnotics and Sedatives; D009638:Norepinephrine; D015742:Propofol