Alcohol withdrawal syndrome sedation

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    02-Jun-2015

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Alcohol withdrawal syndrome; a brief review on sedation of the agitated delirious patient.

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  • 1. Alcohol Withdrawal SyndromeSedationjavier benitez (@jvrbntz) In 5 slides or less...

2. Case PresentationA middle age man with multiple comorbiditiesincluding previous ICU admissions for AWSwith delirium tremens. He is in the hospitalthis time with AWS and agitation difficult tocontrol.Discuss the progression of sedative agents thatmay be used in agitated patients with severedelirium? 3. Progressively IV bolus of benzodiazepines orbarbiturates Associated with decrease length of stay, mechanical ventilation, pneumonia in not severely agitated Phenobarb: narrow therapeutic window, long half-life Titrated IV infusion of benzodiazepines Consider in more severe agitated patients,especially ifsedation was not achieved with IV bolus Addition of IV rescue to #1 or #2 Propofol: risks of hypotension, bradycardia, propofol infusion syndrome Dexmedetomedine: a agonist > clonidine, less deliriumThese meds have the risk of respiratory depression 4. ReferenceAlcohol Withdrawal SyndromeRichard W. Carlson, MD, PhD, Nivedita N. Kumar, MD, Edna Wong-Mckinstry, MD, Srikala Ayyagari, MD, Nitin Puri, MD, Frank K. Jackson,Shivaramaiah Shashikumar, MDCritical Care Clinics, Volume 28, Issue 4 , Pages 549-585, October 2012

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