Comparison of Intravenous Ethanol Versus Diazepam for Alcohol Withdrawal Prophylaxis in the Trauma ICU: Results of a Randomized Trial

Weinberg, Jordan A.; Magnotti, Louis J.; Fischer, Peter; Edwards, Norma M.; Schroeppel, Thomas J.; Fabian, Timothy C.; Croce, Martin A.

doi:10.1097/ta.0b013e31815eb12a

Cited by 54 publications

(41 citation statements)

References 13 publications

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“…102,111 Severe alcohol withdrawal syndrome that is refractory to high-dose benzodiazepines has been treated successfully with the addition of phenobarbital or propofol. 104,112 Weinberg et al 113 have shown the use of IV alcohol infusion to be as equally effective as diazepam in the prevention of In our experience, patients with AUDs may develop signs of physical and possibly "autonomic agitation" with inadequate sedation. 89 Patients may develop fever, tachycardia, and hypertension when sedation is inadequate, although evidence for these occurring in broad cohorts of patients with AUDs are lacking because diagnosis of alcohol withdrawal syndrome rests on patients self-reporting symptoms of irritability, nausea, and headache.…”

Section: Management Of Sedationmentioning

confidence: 96%

Alcohol-Use Disorders in the Critically Ill Patient

Wit

Jones

Sessler

et al. 2010

Chest

101

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A lcohol-use disorders (AUDs) encompass a spectrum of disorders, including excessive use, abuse, dependence, and addiction. Abuse occurs when a patient experiences adverse socioeconomic or health consequences related to the use of the substance. 1 Dependence is present either when the patient experiences withdrawal symptoms on discontinuation of the substance or when larger amounts are necessary to achieve the desired effect. 1 Addiction is indicated by the patient experiencing a compulsive craving for a substance. 1 At any one time, a patient may have more than one of these disorders simultaneously present. The National Institutes of Health 2 have put forth guidelines that quantify excessive and unhealthy use of alcohol; a level of use above this threshold increases a patient's risk for health problems. 3 Men aged Յ 65 years who consume more than four standard drinks in a typical day or . 14 standard drinks in a typical week have excessive and unhealthy alcohol consumption. These volumes are halved for women of all ages and men aged .

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Section: Management Of Sedationmentioning

confidence: 96%

Alcohol-Use Disorders in the Critically Ill Patient

Wit

Jones

Sessler

et al. 2010

Chest

101

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show abstract

“…However, the many disadvantages of ethanol use for this purpose-the need to monitor blood levels, the unpredictable elimination kinetics, and many other possible adverse effects-make it difficult to use this treatment safely and reliably [54][55][56]. A few recent studies have compared ethanol to other commonly used medications and demonstrated no advantage of ethanol with respect to efficacy or adverse sedative effects [57][58][59].…”

Section: Goals Of Aws Treatmentmentioning

confidence: 97%

A rational approach to the treatment of alcohol withdrawal in the ED

Stehman

Mycyk

2013

The American Journal of Emergency Medicine

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“…46 Although some suggest the use of ethanol itself to prevent alcohol withdrawal syndromes, an RCT conducted in trauma patients admitted to the SICU with a history of significant daily alcohol intake compared a strategy of intravenous ethanol with one of scheduled benzodiazapines and found no difference in efficacy or adverse outcomes. 109 More recently Ungur et al 110 published a systematic review of RCTs assessing prevention and therapy for alcohol withdrawal syndromes in trauma, surgical, and medical ICUs. The authors conclude that benzodiazepines are effective and safe for the prevention of alcohol withdrawal syndromes as well as for their treatment.…”

Section: Deliriummentioning

confidence: 98%