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Alcohol Withdrawal Prevention: A Randomized Evaluation of Lorazepam and Ethanol--A Pilot Study.
MedLine Citation:
PMID:  23996419     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background Alcohol withdrawal syndrome, characterized by confusion, agitation, and hallucinations, decreases the safety of patients with acute myocardial infarction. Unexpected hospitalization and sudden cessation of alcohol consumption may increase in-hospital complications and length of stay and even precipitate death. Purpose To perform a randomized evaluation of lorazepam and ethanol/lorazepam to evaluate the safety and efficacy of these 2 strategies for preventing alcohol withdrawal syndrome in patients with acute coronary syndromes. Methods Patients (n = 57) with myocardial infarction were screened for alcohol dependence by using the CAGE questionnaire and randomized to treatment with lorazepam or ethanol with lorazepam. Demographics and complication rates were analyzed by using χ(2) tests (categorical variables) and t tests (continuous variables). Safety (composite complication rates) of the treatment strategy was evaluated by using the Fisher exact test, and length of stay by using the Wilcoxon rank-sum test. Results Safety-associated complication rates (self-extubation, delirium tremens, reinfarction) did not differ between groups (24% lorazepam vs 18% ethanol; P = .56). Days spent in the cardiac intensive care unit (7% lorazepam vs 2% ethanol; P = .32) and overall hospital stay (6% lorazepam vs 6% ethanol; P = .72) did not differ between the 2 groups. Conclusions These preliminary findings suggest that a randomized evaluation of treatment strategies to prevent complications associated with alcohol withdrawal in patients with acute myocardial infarction is safe and feasible.
Authors:
Joyce E Fullwood; Zhila Mostaghimi; Christopher B Granger; Jeffrey B Washam; Wanda Bride; Yanfang Zhao; Bradi B Granger
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Publication Detail:
Type:  JOURNAL ARTICLE    
Journal Detail:
Title:  American journal of critical care : an official publication, American Association of Critical-Care Nurses     Volume:  22     ISSN:  1937-710X     ISO Abbreviation:  Am. J. Crit. Care     Publication Date:  2013 Sep 
Date Detail:
Created Date:  2013-9-2     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9211547     Medline TA:  Am J Crit Care     Country:  -    
Other Details:
Languages:  ENG     Pagination:  398-406     Citation Subset:  -    
Affiliation:
Joyce E. Fullwood is a nurse manager for operations, Zhila Mostaghimi is a clinical nurse, and Jeffrey B. Washam is a clinical pharmacist in the cardiac intensive care unit at Duke University Hospital in Durham, North Carolina. Christopher B. Granger is the medical director of cardiac intensive care at Duke Clinical Research Institute in Durham, North Carolina. Wanda Bride is the associate chief nursing officer for cardiovascular services at Duke University Hospital. Yanfang Zhao is a statistician at the Duke Translational Nursing Institute in Durham, North Carolina. Bradi B. Granger is a cardiovascular clinical nurse specialist at Duke University Health System and an associate professor in the Duke University School of Nursing in Durham, North Carolina.
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