• Users Online: 661
  • Print this page
  • Email this page
REVIEW ARTICLE
Year : 2019  |  Volume : 3  |  Issue : 1  |  Page : 38-42

Management of heavy smokers in the intensive care unit


Department of Pharmaceutical Care, Ministry of the National Guard Health Affairs; Department of Pharmacy Practice, College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia

Correspondence Address:
Jawaher Grmaish
Department of Pharmaceutical Care, Ministry of the National Guard Health Affairs, Riyadh; College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Riyadh
Saudi Arabia
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2543-1854.259478

Rights and Permissions

Quitting smoking abruptly can precipitate the nicotine withdrawal syndrome, characterized by psychological and physical components. Data from critically ill patients have shown that active smokers are more likely to suffer from psychomotor agitation, self-removal of tubes and catheters, need for physical restraint, and therefore usually require higher doses of sedatives, neuroleptics, and analgesic agents. Furthermore, smokers admitted to the intensive care unit (ICU) experience delirium or agitation, which increases the length of hospital stay and the cost of medical care. Nicotine replacement therapy (NRT) has been shown to be safe and effective in the outpatient setting in smokers who intended to quit. However, the management of nicotine withdrawal symptoms in critically ill patients is controversial. Several studies have identified that treating nicotine withdrawal symptoms with NRT can be beneficial while others suggest that it can potentially increase mortality in critically ill patients. In the absence of high-quality data, NRT cannot currently be recommended for routine use to prevent delirium or to reduce hospital or ICU mortality in critically ill smokers. From the currently available data, it seems that the use of NRT in critically ill patients should be limited to selected patients where the potential benefit clearly outweighs the risk. To establish definitive conclusions regarding the use of NRT in smokers admitted to the ICU, it is necessary to carry out well-designed prospective studies with a sample of adequate size to limit the confounding factors and biases present in the current retrospective observational studies.


[FULL TEXT] [PDF]*
Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed1730    
    Printed108    
    Emailed0    
    PDF Downloaded169    
    Comments [Add]    

Recommend this journal