Opioid, sedative, preadmission medication and iatrogenic withdrawal risk in UK adult critically ill patients: a point prevalence study

• DOI: 10.1007/s11096-023-01614-9
• Publication Date: 2023-07-15T16:01:46Z
• Authors: Rebekah Eadie; Cathrine A. McKenzie; Daniel Hadfield; Nicola J. Kalk; Scott Bolesta; Martin Dempster; Daniel F. McAuley; Bronagh Blackwood
• Keywords: Adult; Analgesics; Critical Illness; Iatrogenic Disease; 610; Opioids critical care; United Kingdom; 3. Good health; Substance Withdrawal Syndrome; Analgesics, Opioid; Sedatives; Prevalence; Humans; Hypnotics and Sedatives; Cross-sectional study; Research Article

Iatrogenic withdrawal syndrome, after exposure medication known to cause is recognised, yet under described in adult intensive care.To investigate, opioid, sedation, and preadmission practice critically ill adults with focus on aspects associated iatrogenic syndrome.One-day point prevalence study UK care units (ICUs). We collected ICU admission and/or substances potential, sedation policy, opioid sedative use, dose, duration.Thirty-seven from 39 participating ICUs contributed data 386 patients. The rate for parenteral was 56.1% (212 patients). Twenty-three (59%) had no sedation/analgesia screened withdrawal. Patient medications withdrawal-potential included antidepressants or antipsychotics (43, 20.3%) nicotine (41, 19.3%). Of 212 patients, 202 (95.3%) received opioids, 163 (76.9%) sedatives 153 (72.2%) both. Two hundred two patients opioids: 167 (82.7%) by continuous infusions 90 (44.6%) longer than 96-h. One sixty-three sedatives: 157 (77.7%) 74 (45.4%) 96-h.Opioid syndrome potential rates were high, a high proportion of sedative/analgesic policies. Nearly half opioids 96-h placing them at risk No unit reported using validated tool assessment.