Blog
About

10
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Repetitive Myocardial Infarctions Secondary to Delirium Tremens

      1 , * , 2

      Case Reports in Critical Care

      Hindawi Publishing Corporation

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Delirium tremens develops in a minority of patients undergoing acute alcohol withdrawal; however, that minority is vulnerable to significant morbidity and mortality. Historically, benzodiazepines are given intravenously to control withdrawal symptoms, although occasionally a more substantial medication is needed to prevent the devastating effects of delirium tremens, that is, propofol. We report a trauma patient who required propofol sedation for delirium tremens that was refractory to benzodiazepine treatment. Extubed prematurely, he suffered a non-ST segment myocardial infarction followed by an ST segment myocardial infarction requiring multiple interventions by cardiology. We hypothesize that his myocardial ischemia was secondary to an increased myocardial oxygen demand that occurred during his stress-induced catecholamine surge during the time he was undertreated for delirium tremens. This advocates for the use of propofol for refractory benzodiazepine treatment of delirium tremens and adds to the literature on the instability patients experience during withdrawal.

          Related collections

          Most cited references 13

          • Record: found
          • Abstract: found
          • Article: not found

          Successful use of propofol in refractory delirium tremens.

          Alcohol withdrawal is a common problem encountered by emergency physicians, with delirium tremens (DT) as the extreme manifestation. DT is a true medical emergency. Although benzodiazepines are the mainstay of therapy, some patients require massive amounts to control their symptoms. We report the successful use of propofol for DT refractory to benzodiazepines in a 42-year-old alcoholic man. We briefly discuss alcohol withdrawal, as well as the pharmacokinetics and adverse affects of propofol. The use of propofol in treating DT refractory to benzodiazepines has previously not been reported.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Refractory delirium tremens treated with propofol: a case series.

             P Marik,  C McCowan (2000)
            Delirium tremens, the most serious manifestation of alcohol withdrawal, occurs in approximately 5% of hospitalized alcoholics and has a mortality rate approaching 15%. Patients with delirium tremens are usually treated in an intensive care unit in which benzodiazepines form the cornerstone of therapy. In this report, we describe four patients who proved refractory to high doses of benzodiazepines and were successfully treated with a propofol infusion.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Alcohol, nicotine, and iatrogenic withdrawals in the ICU.

              The neurophysiology, risk factors, and screening tools associated with alcohol withdrawal syndrome in the ICU are reviewed. Alcohol withdrawal syndrome assessment and its treatment options are discussed. Description of nicotine withdrawal and related publications specific to the critically ill are also reviewed. A brief comment as to sedative and opiate withdrawal follows.
                Bookmark

                Author and article information

                Journal
                Case Rep Crit Care
                Case Rep Crit Care
                CRICC
                Case Reports in Critical Care
                Hindawi Publishing Corporation
                2090-6420
                2090-6439
                2014
                12 August 2014
                : 2014
                Affiliations
                1Department of Surgery, Monmouth Medical Center, Long Branch 300 2nd Avenue, Long Branch, NJ 07760, USA
                2Department of Trauma & Critical Care Surgery, Jersey Shore University Medical Center, Neptune, NJ 07753, USA
                Author notes

                Academic Editor: Chiara Lazzeri

                Article
                10.1155/2014/638493
                4145389
                Copyright © 2014 D. Schwartzberg and A. Shiroff.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                Categories
                Case Report

                Comments

                Comment on this article