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This study suggests that ketamine can safely be used to avoid intubation and may decrease length of intensive care unit stay.
Severe alcohol withdrawal, or delirium tremens (DT), is a life-threatening condition that can require massive doses of benzodiazepines or barbiturates (GABA agonists), which can require intubation and prolonged intensive care unit (ICU) care. These authors studied a retrospective sample of adult patients admitted to a single ICU with DT to determine whether adjunctive therapy with ketamine improved outcomes.
They compared outcomes in 29 patients who received symptom-triggered therapy with GABA agonists with outcomes in 34 patients who were treated after initiation of a guideline that added an intravenous ketamine infusion (0.15–0.3 mg/kg/hour) to GABA agonist therapy. Using multivariable modeling that accounted for initial ethanol level and the total amount of GABA agonist required for treatment, patients who received ketamine had significantly lower rates of intubation (29% vs. 76% for patients who did not receive ketamine) and shorter ICU stay (5.7 days vs. 11.2 for patients who did not receive ketamine). There were no reported adverse events.
ON A NORMAL DAY OF WORK, THIS IS WHERE YOU CAN FIND ME:
BUT AS SOON AS THE CLOCK HITS 5PM ON FRIDAY, OUT COMES THE WINE, AND THE LARGEST GLASS I CAN FIND:
BEFORE I HEAD HOME TO START THE NIGHT, I GET A QUICK WORKOUT IN:
THEN AFTER MY WORKOUT, IT’S TIME TO START THE NIGHT THE ONLY WAY I KNOW HOW: