Alcohol Withdrawal Prevention: A Randomized Evaluation of Lorazepam and Ethanol–A Pilot Study.

Link to article at PubMed

Alcohol Withdrawal Prevention: A Randomized Evaluation of Lorazepam and Ethanol--A Pilot Study.

Am J Crit Care. 2013 Sep;22(5):398-406

Authors: Fullwood JE, Mostaghimi Z, Granger CB, Washam JB, Bride W, Zhao Y, Granger BB

Background Alcohol withdrawal syndrome, characterized by confusion, agitation, and hallucinations, decreases the safety of patients with acute myocardial infarction. Unexpected hospitalization and sudden cessation of alcohol consumption may increase in-hospital complications and length of stay and even precipitate death. Purpose To perform a randomized evaluation of lorazepam and ethanol/lorazepam to evaluate the safety and efficacy of these 2 strategies for preventing alcohol withdrawal syndrome in patients with acute coronary syndromes. Methods Patients (n = 57) with myocardial infarction were screened for alcohol dependence by using the CAGE questionnaire and randomized to treatment with lorazepam or ethanol with lorazepam. Demographics and complication rates were analyzed by using χ(2) tests (categorical variables) and t tests (continuous variables). Safety (composite complication rates) of the treatment strategy was evaluated by using the Fisher exact test, and length of stay by using the Wilcoxon rank-sum test. Results Safety-associated complication rates (self-extubation, delirium tremens, reinfarction) did not differ between groups (24% lorazepam vs 18% ethanol; P = .56). Days spent in the cardiac intensive care unit (7% lorazepam vs 2% ethanol; P = .32) and overall hospital stay (6% lorazepam vs 6% ethanol; P = .72) did not differ between the 2 groups. Conclusions These preliminary findings suggest that a randomized evaluation of treatment strategies to prevent complications associated with alcohol withdrawal in patients with acute myocardial infarction is safe and feasible.

PMID: 23996419 [PubMed - as supplied by publisher]

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