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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 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. If left untreated, it may progress to delirium tremens (DTs) in 3–5 % cases (Schuckit, N Engl J Med, 371(22):2109–2113, 2014; Young et al., Ann Emerg Med, 16(8):847–850, 1987). 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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Authors and Affiliations

  1. Division of Pulmonary and Critical Care Medicine, University of Vermont Medical Center, Burlington, VT, USA

    Lucas A. Mikulic & Garth W. Garrison

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  1. Lucas A. Mikulic
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  2. Garth W. Garrison
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Correspondence to Garth W. Garrison .

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Editors and Affiliations

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

    Robert C. Hyzy

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Mikulic, L.A., Garrison, G.W. (2017). Management of Alcohol Withdrawal Syndromes. In: Hyzy, R. (eds) Evidence-Based Critical Care. Springer, Cham. https://doi.org/10.1007/978-3-319-43341-7_92

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  • DOI: https://doi.org/10.1007/978-3-319-43341-7_92

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-43339-4

  • Online ISBN: 978-3-319-43341-7

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