Evidence map›Paper›PMID 38481543›Full record

ArticleCritical care explorations2024

Practices and Outcomes Associated With Sublingual Buprenorphine Use in a Critically Ill Population.

Denis J Vanini, Jenna M Corvelli, Kaylee M Maynard, Stephen H Rappaport, Gina Grasso, Raquel Jones, Nicole M Acquisto, Rachel F Schult

Open access · goldAbstract read
In one paragraph

Article in Critical care explorations, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
2.1field-weighted citation impact, top 14% 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

1 citing paper in PubMed, 5 citations in OpenAlex.

  1. 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

8 authors at 1 institution in 1 country.

Denis J VaniniDepartment of Pharmacy, University of Rochester Medical Center, Rochester, NY.
Jenna M CorvelliDepartment of Pharmacy, University of Rochester Medical Center, Rochester, NY.
Kaylee M MaynardDepartment of Pharmacy, University of Rochester Medical Center, Rochester, NY.
Stephen H RappaportDepartment of Pharmacy, University of Rochester Medical Center, Rochester, NY.
Gina GrassoDepartment of Pharmacy, University of Rochester Medical Center, Rochester, NY.
Raquel JonesDepartment of Pharmacy, University of Rochester Medical Center, Rochester, NY.
Nicole M AcquistoDepartment of Pharmacy, University of Rochester Medical Center, Rochester, NY.
Rachel F SchultDepartment of Pharmacy, University of Rochester Medical Center, Rochester, NY.
University of Rochester Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

importanceBuprenorphine for opioid use disorder (OUD) is commonly used in the outpatient setting with increasing use in hospitalized patients. However, there is limited literature describing its use in critically ill populations.

objectivesThe primary objective was to report the practices of buprenorphine prescribing among ICU teams. We also assessed the effect of a novel initiation strategy on opioid requirements in the ICU and the incidence of precipitated withdrawal. DESIGN SETTING

participantsSingle-center, retrospective, descriptive study of patients receiving buprenorphine in the ICU. MAIN OUTCOMES AND MEASURES: The main outcome was to describe the use of buprenorphine in ICU patients through indication, initiation strategy, dosing information, and time from ICU admission to the first dose. We also detailed the incidence of precipitated withdrawal overall and the difference in opioid requirements before and after a low-dose induction strategy (buprenorphine initiated while receiving full agonist opioids [5-d titration from 150 μg to 4 mg four times daily]).

resultsA total of 153 patients were included. Most patients (86.3%) received buprenorphine for treatment of OUD. Of the 75 patients taking buprenorphine before admission, 46 (61%) had it restarted within 24 hours of ICU admission. Among 95 patients requiring buprenorphine induction, 57 (60%) underwent standard induction and 38 (40%) underwent low-dose induction, with only one instance of precipitated withdrawal. Median morphine milligram equivalents (MMEs) of concomitant full agonist opioids in patients completing low-dose induction decreased from 1057.5 mg to 262.5 mg in the 24 hours before initiation compared with the 24 hours after target buprenorphine dose was reached ( CONCLUSIONS AND RELEVANCE: Use of sublingual buprenorphine was most often in patients with OUD. Timely continuation of home buprenorphine in the ICU was suboptimal. Both standard and low-dose induction strategies appear to be safe with a low risk of precipitating withdrawal. When implemented appropriately, low-dose buprenorphine induction may lead to significant reduction in full agonist opioids in critically ill patients.

Indexed as

buprenorphinecritical carecritical illnessopioid-related disorderssubstance withdrawal syndrome

Identifiers

PMID38481543
PMCPMC10936989
OpenAlexW4392686414

What OpenQuestion holds

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LicenceCC BY-NC-ND
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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.