| Title |
Opioid-associated iatrogenic withdrawal in critically ill adult patients: a multicenter prospective observational study
|
|---|---|
| Published in |
Annals of Intensive Care, September 2017
|
| DOI | 10.1186/s13613-017-0310-5 |
| Pubmed ID | |
| Authors |
Pan Pan Wang, Elaine Huang, Xue Feng, Charles-André Bray, Marc M. Perreault, Philippe Rico, Patrick Bellemare, Paul Murgoi, Céline Gélinas, Annie Lecavalier, Dev Jayaraman, Anne Julie Frenette, David Williamson |
| Abstract |
Opioids and benzodiazepines are frequently used in the intensive care unit (ICU). Regular use and prolonged exposure to opioids in ICU patients followed by abrupt tapering or cessation may lead to iatrogenic withdrawal syndrome (IWS). IWS is well described in pediatrics, but no prospective study has evaluated this syndrome in adult ICU patients. The objective of this study was to determine the incidence of IWS caused by opioids in a critically ill adult population. This multicenter prospective cohort study was conducted at two level-1 trauma ICUs between February 2015 and September 2015 and included 54 critically ill patients. Participants were eligible if they were 18 years and older, mechanically ventilated and had received more than 72 h of regular intermittent or continuous intravenous infusion of opioids. For each enrolled patient and per each opioid weaning episode, presence of IWS was assessed by a qualified ICU physician or senior resident according to the 5th edition of Diagnostic and Statistical Manual of Mental Disorders criteria for opioid withdrawal. The population consisted mostly of males (74.1%) with a median age of 50 years (25th-75th percentile 38.2-64.5). The median ICU admission APACHE II score was 22 (25th-75th percentile 12.0-28.2). The overall incidence of IWS was 16.7% (95% CI 6-27). The median cumulative opioid dose prior to weaning was higher in patients with IWS (245.7 vs. 169.4 mcg/kg, fentanyl equivalent). Patients with IWS were also exposed to opioids for a longer period of time as compared to patients without IWS (median 151 vs. 125 h). However, these results were not statistically significant. IWS was occasionally observed in this very specific population of mechanically ventilated, critically ill ICU patients. Further studies are needed to confirm these preliminary results and identify risk factors. |
X Demographics
The data shown below were collected from the profiles of 22 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 9 | 41% |
| United Kingdom | 2 | 9% |
| Slovenia | 1 | 5% |
| Spain | 1 | 5% |
| Mexico | 1 | 5% |
| Malaysia | 1 | 5% |
| Belgium | 1 | 5% |
| Colombia | 1 | 5% |
| Unknown | 5 | 23% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 12 | 55% |
| Scientists | 5 | 23% |
| Practitioners (doctors, other healthcare professionals) | 5 | 23% |
Mendeley readers
The data shown below were compiled from readership statistics for 73 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 73 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Other | 10 | 14% |
| Researcher | 9 | 12% |
| Student > Master | 9 | 12% |
| Student > Ph. D. Student | 7 | 10% |
| Student > Doctoral Student | 7 | 10% |
| Other | 18 | 25% |
| Unknown | 13 | 18% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 25 | 34% |
| Nursing and Health Professions | 18 | 25% |
| Pharmacology, Toxicology and Pharmaceutical Science | 3 | 4% |
| Biochemistry, Genetics and Molecular Biology | 2 | 3% |
| Engineering | 2 | 3% |
| Other | 9 | 12% |
| Unknown | 14 | 19% |
Attention Score in Context
This research output has an Altmetric Attention Score of 12. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 17 February 2020.
All research outputs
#2,967,407
of 24,754,968 outputs
Outputs from Annals of Intensive Care
#382
of 1,143 outputs
Outputs of similar age
#53,146
of 321,350 outputs
Outputs of similar age from Annals of Intensive Care
#4
of 22 outputs
Altmetric has tracked 24,754,968 research outputs across all sources so far. Compared to these this one has done well and is in the 87th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 1,143 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 18.4. This one has gotten more attention than average, scoring higher than 66% of its peers.
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We're also able to compare this research output to 22 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 86% of its contemporaries.