Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Nicotine withdrawal and agitation in ventilated critically ill patients. | Lucidarme et al. Critical Care 2010 14 R58 http content 14 2 R58 c CRITICAL CARE RESEARCH Open Access Nicotine withdrawal and agitation in ventilated critically ill patients Olivier Lucidarme1 Amélie Seguin2 Cédric Daubin2 Michel Ramakers2 Nicolas Terzi2 Patrice Beck1 Pierre Charbonneau2 and Damien du Cheyron 2 3 Abstract Introduction Smoking is highly addictive and nicotine abstinence is associated with withdrawal syndrome in hospitalized patients. In this study we aimed to evaluate the impact of sudden nicotine abstinence on the development of agitation and delirium and on morbidities and outcomes in critically ill patients who required respiratory support either noninvasive ventilation or intubation and mechanical ventilation. Methods We conducted a prospective observational study in two intensive care units ICUs . The 144 consecutive patients admitted to ICUs and requiring mechanical ventilation for 48 hours were included. Smoking status was assessed at ICU admission by using the Fagerstrom Test of Nicotine Dependence FTND . Agitation with the SedationAgitation Scale SAS and delirium with the Intensive Care Delirium Screening Checklist ICDSC were tested twice daily during the ICU stay. Agitation and delirium were defined by SAS 4 and ICDSC 4 respectively. Nosocomial complications and outcomes were evaluated. Results Smokers n 44 were younger and more frequently male and were more likely to have a history of alcoholism and to have septic shock as the reason for ICU admission than were nonsmokers. The incidence of agitation but not delirium increased significantly in the smoker group 64 versus 32 P . Nicotine abstinence was associated with higher incidences of self-removal of tubes and catheters and with more interventions including the need for supplemental sedatives analgesics neuroleptics and physical restraints. Sedation-free days ventilator-free days length of stay and mortality in ICUs did not differ between groups. Multivariate analysis
