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Management of Alcohol Withdrawal Syndromes

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Evidence-Based Critical Care

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Abstract

Alcohol Withdrawal Syndrome (AWS) accounts for 16–31% of all intensive care unit (ICU) admissions and carries with it a mortality of 15% if left untreated. The symptoms of alcohol withdrawal can be divided into three broad categories: CNS excitation, autonomic hyperactivity, and psychosis. When psychosis or delirium tremens (DTs) is present, mortality is 3–5%. The management of alcohol withdrawal is directed towards alleviating symptoms of withdrawal and avoiding its progression into seizures or DTs. Current management is centered on the administration of benzodiazepines in symptom-triggered escalating dose strategy. Barbiturates can be administered together with benzodiazepines or as monotherapy for the treatment of AWS. Other medications, like propofol, dexmedetomidine, clonidine, or haloperidol have been used successfully as adjuvant therapy to ameliorate AWS symptoms.

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Author information

Authors and Affiliations

  1. Morton Plant Hospital, Clearwater, FL, USA

    Lucas A. Mikulic

  2. University of Vermont Medical Center, Burlington, VT, USA

    Garth W. Garrison

Authors
  1. Lucas A. Mikulic
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  2. Garth W. Garrison
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Corresponding author

Correspondence to Garth W. Garrison .

Editor information

Editors and Affiliations

  1. Division of Pulmonary and Critical Care, University of Michigan, Ann Arbor, MI, USA

    Robert C. Hyzy

  2. Division of Pulmonary and Critical Care, University of Michigan, Ann Arbor, MI, USA

    Jakob McSparron

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Mikulic, L.A., Garrison, G.W. (2020). Management of Alcohol Withdrawal Syndromes. In: Hyzy, R.C., McSparron, J. (eds) Evidence-Based Critical Care. Springer, Cham. https://doi.org/10.1007/978-3-030-26710-0_104

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  • DOI: https://doi.org/10.1007/978-3-030-26710-0_104

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-26709-4

  • Online ISBN: 978-3-030-26710-0

  • eBook Packages: MedicineMedicine (R0)

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