Evidence map›Paper›PMID 22620986›Full record

ArticleAnnals of intensive care2012

Dexmedetomidine as adjunct treatment for severe alcohol withdrawal in the ICU.

Samuel G Rayner, Craig R Weinert, Helen Peng, Stacy Jepsen, Alain F Broccard, Study Institution

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of intensive care, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers.

0numbers the graph read from it
0cells of the map it votes in
25citing papers in PubMed
9.4field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

25 citing papers in PubMed, 101 citations in OpenAlex.

  1. Alcohol withdrawal prevention: a randomized evaluation of lorazepam and ethanol--a pilot study.American journal of critical care : an official publication, American Association of Critical-Care Nurses · 2013
    Trial
  2. Article
  3. Article
  4. Article
  5. Review
  6. Article
  7. Article
  8. Article
  9. Delirium Tremens: Assessment and Management.Journal of clinical and experimental hepatology · 2018
    Review
  10. Adjunctive Use of Ketamine for Benzodiazepine-Resistant Severe Alcohol Withdrawal: a Retrospective Evaluation.Journal of medical toxicology : official journal of the American College of Medical Toxicology · 2018
    Article
  11. Review
  12. Treatment of Severe Alcohol Withdrawal: A Focus on Adjunctive Agents.The Journal of pharmacy technology : jPT : official publication of the Association of Pharmacy Technicians · 2017
    Article
  13. Article
  14. Article
  15. Article
  16. Article
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  18. Article
  19. Is it prime time for alpha2-adrenocepter agonists in the treatment of withdrawal syndromes?Journal of medical toxicology : official journal of the American College of Medical Toxicology · 2014
    Review
  20. Novel use of dexmedetomidine for the treatment of anticholinergic toxidrome.Journal of medical toxicology : official journal of the American College of Medical Toxicology · 2014
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 1 country.

Samuel G RaynerUniversity of Minnesota Medical School, 1803 E John Street Seattle, Seattle, WA 98112, USA. rayn0011@umn.edu.
Craig R Weinert
Helen Peng
Stacy Jepsen
Alain F Broccard
Study Institution
Fairview Southdale Hospital · USUniversity of Minnesota · USSeattle University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPatients undergoing alcohol withdrawal in the intensive care unit (ICU) often require escalating doses of benzodiazepines and not uncommonly require intubation and mechanical ventilation for airway protection. This may lead to complications and prolonged ICU stays. Experimental studies and single case reports suggest the α2-agonist dexmedetomidine is effective in managing the autonomic symptoms seen with alcohol withdrawal. We report a retrospective analysis of 20 ICU patients treated with dexmedetomidine for benzodiazepine-refractory alcohol withdrawal.

methodsRecords from a 23-bed mixed medical-surgical ICU were abstracted from November 2008 to November 2010 for patients who received dexmedetomidine for alcohol withdrawal. The main analysis compared alcohol withdrawal severity scores and medication doses for 24 h before dexmedetomidine therapy with values during the first 24 h of dexmedetomidine therapy.

resultsThere was a 61.5% reduction in benzodiazepine dosing after initiation of dexmedetomidine (n = 17; p < 0.001) and a 21.1% reduction in alcohol withdrawal severity score (n = 11; p = .015). Patients experienced less tachycardia and systolic hypertension following dexmedetomidine initiation. One patient out of 20 required intubation. A serious adverse effect occurred in one patient, in whom dexmedetomidine was discontinued for two 9-second asystolic pauses noted on telemetry.

conclusionsThis observational study suggests that dexmedetomidine therapy for severe alcohol withdrawal is associated with substantially reduced benzodiazepine dosing, a decrease in alcohol withdrawal scoring and blunted hyperadrenergic cardiovascular response to ethanol abstinence. In this series, there was a low rate of mechanical ventilation associated with the above strategy. One of 20 patients suffered two 9-second asystolic pauses, which did not recur after dexmedetomidine discontinuation. Prospective trials are warranted to compare adjunct treatment with dexmedetomidine versus standard benzodiazepine therapy.

Identifiers

PMID22620986
PMCPMC3464179
OpenAlexW2143780481

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.