This question is for Jessica Mason; Mel Herbert; Sean Nordt; and Stuart Swadron regarding the C3 segment on Alcohol Withdrawal.
What kills people in ETOH withdrawal?
I did a recent teaching session w/ nursing staff and residents about pathophys of withdrawal and treatment and I was asked the same question and I couldn't give a crisp answer.
Basically, for agitation and excited state 2/2 downregulation of GABA activity w/ treat w/ phenobarb and/or benzos (and maybe some 2ndary agents). But, by treating agitation and hopefully preventing withdrawal seizures, are we eliminating all-cause mortality?
Of course we're doing further workup and fixing problems as we find them. But we do this for all acutely ill individuals . . . . Which makes me ask: by treating patients for alcohol withdrawal, are we preventing death by treating with benzo/pheno, or are we reducing mortality by doing appropriate workups to prevent other causes of death in this high-risk population?
Doing a lit search on pubmed, corependium and up-to-date I couldn't find a satisfactory answer. Can you folks help me out?
Thanks a lot.
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tom f. - January 9, 2022 1:21 AM
Nice, Jess and Mel
Will L. - April 8, 2022 5:57 PM
This question is for Jessica Mason; Mel Herbert; Sean Nordt; and Stuart Swadron regarding the C3 segment on Alcohol Withdrawal.
What kills people in ETOH withdrawal?
I did a recent teaching session w/ nursing staff and residents about pathophys of withdrawal and treatment and I was asked the same question and I couldn't give a crisp answer.
Basically, for agitation and excited state 2/2 downregulation of GABA activity w/ treat w/ phenobarb and/or benzos (and maybe some 2ndary agents). But, by treating agitation and hopefully preventing withdrawal seizures, are we eliminating all-cause mortality?
Of course we're doing further workup and fixing problems as we find them. But we do this for all acutely ill individuals . . . . Which makes me ask: by treating patients for alcohol withdrawal, are we preventing death by treating with benzo/pheno, or are we reducing mortality by doing appropriate workups to prevent other causes of death in this high-risk population?
Doing a lit search on pubmed, corependium and up-to-date I couldn't find a satisfactory answer. Can you folks help me out?
Thanks a lot.