ArticleAnnals of intensive care2016
Unsuspected serotonin toxicity in the ICU.
Article in Annals of intensive care, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 22 citations in OpenAlex.
- Review
- Predictors of Serotonin Syndrome in Acute Poisoning with 5-Hydroxytryptamine Modulators.Toxics · 2024Article
- Serotonin syndrome controversies: A need for consensus.World journal of critical care medicine · 2024Review
- Mechanisms underlying delirium in patients with critical illness.Frontiers in aging neuroscience · 2024Review
- Recognizing serotonin syndrome in the intensive care unit: a case report of serotonin syndrome in a patient taking amitriptyline, buprenorphine, pregabalin, and fentanyl.AME case reports · 2024Article
- Postoperative Serotonin Syndrome Following Administration of Preoperative Intrapulmonary Methylene Blue and Intraoperative Granisetron: A Case Report.The American journal of case reports · 2022Article
- Unprovoked serotonin syndrome-like presentation of SARS-CoV-2 infection: A small case series.SAGE open medical case reports · 2021Article
- Interventions of a clinical pharmacist in a medical intensive care unit - A retrospective analysis.Bosnian journal of basic medical sciences · 2020Article
- The 2014 updated version of the Confusion Assessment Method for the Intensive Care Unit compared to the 5th version of the Diagnostic and Statistical Manual of Mental Disorders and other current methods used by intensivists.Annals of intensive care · 2018Article
- Knowledge, Attitude, and Practice (KAP) Study on Serotonin Syndrome Among Neuro Physicians.Annals of Indian Academy of NeurologyArticle
Corrections and comments
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Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDelirium is a frequently occurring syndrome in patients admitted to the intensive care unit (ICU) or medium care unit (MCU), yet the pathophysiology remains poorly understood. An excess of central serotonin can lead to an altered mental status, associated with autonomic hyperactivity, and neuromuscular excitation. Drugs with serotonergic properties are frequently and for prolonged periods administered to ICU/MCU patients. Therefore, central serotonergic toxicity may constitute a predisposing, contributing or precipitating factor in the emergence of delirium. The purpose of the present study is to determine the number of patients admitted to the ICU or MCU who are diagnosed with delirium and who show characteristics of serotonin toxicity in association with the administration of serotonergic drugs.
methodsDuring a 10-week prospective observational cohort study in the ICU and MCU, patients aged 18 or older, diagnosed with delirium in the ICU or MCU, were included. Patients were considered as delirious in case of a positive CAM-ICU and/or at the start of haloperidol prescription on suspicion of delirium. Once included, patients were screened for recent administered serotonergic drugs and screened for physical signs associated with serotonin toxicity by a standardized physical examination by a specifically trained physician.
resultsA total of 61 patients diagnosed with delirium were enrolled. In 44 out of 61 patients (72 %), the use of drugs potentially contributing to serotonergic toxicity was recorded. Out of 44 patients, seven (16 %) patients showed physical signs of serotonin toxicity and in addition met the Hunter serotonin toxicity criteria, suggesting the presence of serotonergic toxicity. None of these patients were recognized as such by the treating physicians.
conclusionsA significant proportion of delirious patients in the ICU might in fact be classified as suffering from central serotonin toxicity. The awareness of potential serotonin toxicity is low among physicians.
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