TY - JOUR
T1 - Nicotine replacement therapy in critically ill patients
T2 - A prospective observational cohort study
AU - Cartin-Ceba, Rodrigo
AU - Warner, David O.
AU - Hays, J. Taylor
AU - Afessa, Bekele
PY - 2011/7
Y1 - 2011/7
N2 - Objective: Smokers admitted to the intensive care unit may receive nicotine replacement therapy to prevent nicotine withdrawal. However, recent studies have questioned the safety of this practice. The objective of this study was to determine the impact of nicotine replacement therapy on the outcomes of critically ill patients. Design: Prospective observational cohort. Setting: The medical intensive care unit of a tertiary academic hospital. Patients: Active smokers admitted to the intensive care unit. Interventions: None. Measurements and Main Results: After excluding 2,411 patients who did not meet the study inclusion criteria, 330 were included in the study, of which 174 patients received and 156 did not receive nicotine replacement therapy. There were no significant differences in the unadjusted hospital mortality between the two groups: 14 patients (7.8%; 95% confidence interval, 4-12) died in the nicotine replacement therapy group as compared with ten patients (6.3%; 95% confidence interval, 2.6-10.3) in the nonnicotine replacement therapy group (p = .59). After adjusting for severity of illness and propensity score for administration of nicotine replacement therapy on intensive care unit admission, nicotine replacement therapy was not associated with increased hospital mortality (odds ratio, 1.4; 95% confidence interval, 0.5-3.9; p = .51). Limitations: Single-center observational study. Conclusions: Nicotine replacement therapy is not associated with increased hospital mortality in critically ill patients. However, we were not able to demonstrate any clinically significant benefit from its use in the intensive care unit setting.
AB - Objective: Smokers admitted to the intensive care unit may receive nicotine replacement therapy to prevent nicotine withdrawal. However, recent studies have questioned the safety of this practice. The objective of this study was to determine the impact of nicotine replacement therapy on the outcomes of critically ill patients. Design: Prospective observational cohort. Setting: The medical intensive care unit of a tertiary academic hospital. Patients: Active smokers admitted to the intensive care unit. Interventions: None. Measurements and Main Results: After excluding 2,411 patients who did not meet the study inclusion criteria, 330 were included in the study, of which 174 patients received and 156 did not receive nicotine replacement therapy. There were no significant differences in the unadjusted hospital mortality between the two groups: 14 patients (7.8%; 95% confidence interval, 4-12) died in the nicotine replacement therapy group as compared with ten patients (6.3%; 95% confidence interval, 2.6-10.3) in the nonnicotine replacement therapy group (p = .59). After adjusting for severity of illness and propensity score for administration of nicotine replacement therapy on intensive care unit admission, nicotine replacement therapy was not associated with increased hospital mortality (odds ratio, 1.4; 95% confidence interval, 0.5-3.9; p = .51). Limitations: Single-center observational study. Conclusions: Nicotine replacement therapy is not associated with increased hospital mortality in critically ill patients. However, we were not able to demonstrate any clinically significant benefit from its use in the intensive care unit setting.
KW - APACHE
KW - intensive care
KW - length of stay
KW - mortality
KW - nicotine
KW - smoking
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U2 - 10.1097/CCM.0b013e31821867b8
DO - 10.1097/CCM.0b013e31821867b8
M3 - Article
C2 - 21494111
AN - SCOPUS:79959674567
SN - 0090-3493
VL - 39
SP - 1635
EP - 1640
JO - Critical care medicine
JF - Critical care medicine
IS - 7
ER -