Special Circumstances | Sedative-Hypnotic Withdrawal

<< Sedative-Hypnotic Drug Withdrawal Syndrome: Recognition and Treatment (Critical Care Topic and Pharmacology CME)

Special Circumstances

Managing Critically Ill Patients

Indications for ICU admission include the following criteria: a need for neurologic and hemodynamic monitoring associated with moderate to heavy sedation; respiratory failure; cardiac disease; hyperthermia; hemodynamic instability; marked fluid, electrolyte, and renal disorders; rhabdomyolysis; and history of prior withdrawal symptoms. Patients with severe hyperthermia, refractory agitation, or severe metabolic acidosis may require endotracheal intubation in order to facilitate administration of higher doses of benzodiazepines and other adjunctive therapies. If rhabdomyolysis is of concern, the use of succinylcholine should be avoided for use with intubation, as it may cause an acute rise in serum potassium that can result in cardiac dysrhythmias. 

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