Uso de dexmedetomidina como tratamiento coadyuvante de síndrome de abstinencia alcohólica: revisión sistemática
| Contribuinte(s) |
Acosta González, Pilar Julieta La Rota Hernández, Jaime Fernando |
|---|---|
| Data(s) |
29/07/2016
|
| Resumo |
El objetivo de este estudio es establecer si la dexmedetomidina (DEX) es segura y efectiva para el manejo coadyuvante de síndrome de abstinencia a alcohol (SAA) a través de la búsqueda de evidencia científica. Metodología: se realiza una revisión sistemática de literatura publicada y no publicada desde enero de 1989 hasta febrero 2016 en PubMed, Embase, Scopus, Bireme, Cochrane library y en otras bases de datos y portales. Los criterios de inclusión fueron ensayos clínicos aleatorizados y no aleatorizados, estudios cuasi-experimentales, estudios de cohorte, y estudios de casos y controles; que incluyeron pacientes mayores de 18 años hospitalizados con diagnóstico de SAA y donde se usó DEX como terapia coadyuvante. Resultados: 7 estudios, 477 pacientes, se incluyeron en el análisis final. Se encontraron dos ensayos clínicos aleatorizados, tres estudios de casos y controles y dos estudios de cohorte retrospectivo. Solo uno de los estudios fue doble ciego y utilizó placebo como comparador. Análisis y conclusiones: en los estudios experimentales se determinan que el uso de DEX como terapia coadyuvante en el manejo de SAA tiene significancia clínica y estadística para disminuir dosis de BZD en las primeras 24 horas de tratamiento; pero no demostraron tener otros beneficios clínicos. En los estudios no aleatorizados existe consenso que relaciona el uso de DEX con menores dosis de BZD de forma temprana. Recomendaciones: no se recomienda el uso de DEX en SAA de forma rutinaria. Se recomienda usar DEX solo en casos en el que exista evidencia fallo terapéutico a BZD. Systematic review about dexmedetomidine adjuntive use in the treatment of alcohol withdrawal syndrome |
| Formato |
application/pdf |
| Identificador | |
| Idioma(s) |
spa |
| Publicador |
Facultad de Medicina |
| Direitos |
info:eu-repo/semantics/openAccess |
| Fonte |
instname:Universidad del Rosario reponame:Repositorio Institucional EdocUR Carlson RW, Kumar NN, Wong-Mckinstry E, Ayyagari S, Puri N, Jackson FK, et al. Alcohol withdrawal syndrome. Crit Care Clin. 2012;28(4):549-85. Gold J, Nelson L. Ethanol withdrawal. Goldfrank's toxicologic emergencies. 9th ed. New York: McGraw-Hill Medical,; 2011. p. 1134-40. Friedmann PD. Clinical practice. Alcohol use in adults. N Engl J Med. 2013;368(4):365-73. Kattimani S, Bharadwaj B. Clinical management of alcohol withdrawal: A systematic review. Ind Psychiatry J. 2013;22(2):100-8. Amato L, Minozzi S, Davoli M. Efficacy and safety of pharmacological interventions for the treatment of the Alcohol Withdrawal Syndrome. Cochrane Database Syst Rev. 2011(6). Ntais C, Pakos E, Kyzas P, Ioannidis JP. Benzodiazepines for alcohol withdrawal. Cochrane Database Syst Rev. 2005(3) Guglielminotti J, Maury E, Alzieu M, Delhotal Landes B, Becquemont L, Guidet B, et al. Prolonged sedation requiring mechanical ventilation and continuous flumazenil infusion after routine doses of clorazepam for alcohol withdrawal syndrome. Intensive Care Med. 1999;25(12):1435-6. Mantz J, Josserand J, Hamada S. Dexmedetomidine: new insights. Eur J Anaesthesiol. 2011;28(1):3-6. Gregoretti C, Moglia B, Pelosi P, Navalesi P. Clonidine in perioperative medicine and intensive care unit: more than an anti-hypertensive drug. Curr Drug Targets. 2009;10(8):799-814. Frazee EN, Personett HA, Leung JG, Nelson S, Dierkhising RA, Bauer PR. Influence of dexmedetomidine therapy on the management of severe alcohol withdrawal syndrome in critically ill patients. J Crit Care. 2014;29(2):298-302. Mueller SW, Preslaski CR, Kiser TH, Fish DN, Lavelle JC, Malkoski SP, et al. A randomized, double-blind, placebo-controlled dose range study of dexmedetomidine as adjunctive therapy for alcohol withdrawal. Crit Care Med. 2014;42(5):1131-9. Gore FM, Bloem PJ, Patton GC, Ferguson J, Joseph V, Coffey C, et al. Global burden of disease in young people aged 10-24 years: a systematic analysis. Lancet. 2011;377(9783):2093-102. Rehm J, Mathers C, Popova S, Thavorncharoensap M, Teerawattananon Y, Patra J. Global burden of disease and injury and economic cost attributable to alcohol use and alcohol-use disorders. Lancet. 2009;373(9682):2223-33. Wang YP, Andrade LH. Epidemiology of alcohol and drug use in the elderly. Curr Opin Psychiatry. 2013;26(4):343-8. Gobierno Nacional de la República de Colombia. Estudio nacional de consumo de sustancias psicoactivas en Colombia - 2013. En; Ministerio de Justicia. Bogotá 2013. de Wit M, Jones DG, Sessler CN, Zilberberg MD, Weaver MF. Alcohol-use disorders in the critically ill patient. Chest. 2010;138(4):994-1003. Rayner SG, Weinert CR, Peng H, Jepsen S, Broccard AF. Dexmedetomidine as adjunct treatment for severe alcohol withdrawal in the ICU. Ann Intensive Care. 2012;2(1):12. Muzyk AJ, Kerns S, Brudney S, Gagliardi JP. Dexmedetomidine for the treatment of alcohol withdrawal syndrome: rationale and current status of research. CNS Drugs. 2013;27(11):913-20. Llano MC, Campuzano M. La chicha, una bebida fermentada a través de la historia: Instituto Colombiano de Antropología; 1994. Association AP. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5®): American Psychiatric Publishing; 2013. Yip L. Ethanol. In: Nelson LS, Lewin NA, Howland MA, Hoffman RS, Goldfrank LR, Flomenbaum N, editors. Goldfrank's Toxicologic Emergencies. Ninth ed. New York: McGraw Hill; 2011. p. 1115-28. Cuesta JD, Restrepo AM. Síndrome de abstinencia alcohólica. In: Peña LM, Arroyave CL, Aristizabal JJ, Gómez UE, editors. Toxicología clínica. 1 ed. Colombia: CIB Corporacion para Investigacion Biologica; 2010. Olsen RW, Spigelman I. GABAA Receptor Plasticity in Alcohol Withdrawal. In: Noebels JL, Avoli M, Rogawski MA, Olsen RW, Delgado-Escueta AV, editors. Jasper's Basic Mechanisms of the Epilepsies. Bethesda (MD): National Center for Biotechnology Information (US); 2012. Reynolds PM, Mueller SW, MacLaren R. A comparison of dexmedetomidine and placebo on the plasma concentrations of NGF, BDNF, GDNF, and epinephrine during severe alcohol withdrawal. Alcohol. 2015;49(1):15-9. Eyer F, Schuster T, Felgenhauer N, Pfab R, Strubel T, Saugel B, et al. Risk assessment of moderate to severe alcohol withdrawal--predictors for seizures and delirium tremens in the course of withdrawal. Alcohol. 2011;46(4):427-33. Sullivan JT, Sykora K, Schneiderman J, Naranjo CA, Sellers EM. Assessment of alcohol withdrawal: the revised clinical institute withdrawal assessment for alcohol scale (CIWA-Ar). Br J Addict. 1989;84(11):1353-7. Schmidt KJ, Doshi MR, Holzhausen JM, Natavio A, Cadiz M, Winegardner JE. A Review of the Treatment of Severe Alcohol Withdrawal. Ann Pharmacother. 2016. Tolonen J, Rossinen J, Alho H, Harjola VP. Dexmedetomidine in addition to benzodiazepine-based sedation in patients with alcohol withdrawal delirium. Eur J Emerg Med. 2013;20(6):425-7. Bielka K, Kuchyn I, Glumcher F. Addition of dexmedetomidine to benzodiazepines for patients with alcohol withdrawal syndrome in the intensive care unit: a randomized controlled study. Ann Intensive Care. 2015;5(1). Albertson TE, Chenoweth J, Ford J, Owen K, Sutter ME. Is It Prime Time for Alpha2-Adrenocepter Agonists in the Treatment of Withdrawal Syndromes? J Med Toxicol. 2014;10(4):369-81. Hoffman BB, Williams FM. Adrenergic Pharmacology. In: Golan DE, Tashjian AH, Armstrong EJ, editors. Principles of pharmacology: the pathophysiologic basis of drug therapy. Third ed: Lippincott Williams & Wilkins; 2011. p. 132-46. Nikolic K, Agbaba D. Imidazoline antihypertensive drugs: selective i(1) -imidazoline receptors activation. Cardiovasc Ther. 2012;30(4):209-16. Muzyk AJ, Fowler JA, Norwood DK, Chilipko A. Role of alpha2-agonists in the treatment of acute alcohol withdrawal. Ann Pharmacother. 2011;45(5):649-57. DeMuro JP, Botros DG, Wirkowski E, Hanna AF. Use of dexmedetomidine for the treatment of alcohol withdrawal syndrome in critically ill patients: A retrospective case series. J Anesth. 2012;26(4):601-5. Prommer E. Review article: dexmedetomidine: does it have potential in palliative medicine? Am J Hosp Palliat Care. 2011;28(4):276-83. Ebert TJ, Hall JE, Barney JA, Uhrich TD, Colinco MD. The effects of increasing plasma concentrations of dexmedetomidine in humans. Anesthesiology. 2000;93(2):382-94. Mohorn PL, Vakkalanka JP, Rushton W, Hardison L, Woloszyn A, Holstege C, et al. Evaluation of dexmedetomidine therapy for sedation in patients with toxicological events at an academic medical center. Clin Toxicology. 2014;52(5):525-30. Rayner SG, Jepsen S, Peng H, Broccard AF. Dexmedetomidine to treat severe alcohol withdrawal refractory to benzodiazepines. American Journal of Respiratory and Critical Care Medicine. 2011;183(1). Abdulmajeed F, Carpenter M, Boutros N. Dexmedetomidine (DEX) as a monotherapy in treating delirium tremens (DTs). Chest. 2013;144(4). Jackson F, Cooper T, Medina-Garcia L, Williamson T, Shashikumar S, Carlson R. Evolving management of alcohol withdrawal syndrome (AWS): Impact on ICU course and complications. Critical Care Medicine. 2012;40(12):286-7. Perry EC. Inpatient management of acute alcohol withdrawal syndrome. CNS Drugs. 2014;28(5):401-10. Hospira®. Product Information: Precedex(TM) intravenous injection, dexmedetomidine HCl intravenous injection. Lake Forest, IL 60045 USA: Hospira, Inc. (per FDA); 2013. Riva JJ, Malik KMP, Burnie SJ, Endicott AR, Busse JW. What is your research question? An introduction to the PICOT format for clinicians. The Journal of the Canadian Chiropractic Association. 2012;56(3):167-71. Kallio A, Scheinin M, Koulu M, Ponkilainen R, Ruskoaho H, Viinamaki O, et al. Effects of dexmedetomidine, a selective alpha 2-adrenoceptor agonist, on hemodynamic control mechanisms. Clin Pharmacol Ther. 1989;46(1):33-42. Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from www.handbook.cochrane.org. Dabrow Woods A, Giometti R, Weeks SM. The use of dexmedetomidine as an adjuvant to benzodiazepine-based therapy to decrease the severity of delirium in alcohol withdrawal in adult intensive care unit patients: a systematic review. JBI Database System Rev Implement Rep. 2015;13(1):224-52. Belka KY. Application of dexmedetomidin for sedation of patients in alcohol withdrawal state in the ICU. Klin Khir. 2015(7):62-4. Linn DD, Loeser KC. Dexmedetomidine for Alcohol Withdrawal Syndrome. Annals of Pharmacotherapy. 2015;49(12):1336-42. Wong A, Smithburger PL, Kane-Gill SL. Review of adjunctive dexmedetomidine in the management of severe acute alcohol withdrawal syndrome. American Journal of Drug and Alcohol Abuse. 2015;41(5):382-91. Awissi DK, Lebrun G, Fagnan M, Skrobik Y. Alcohol, nicotine, and iatrogenic withdrawals in the ICU. Critical Care Medicine. 2013;41(9 SUPPL.1):S57-S68. Savel RH, Kupfer Y. Using dexmedetomidine as adjunctive therapy for patients with severe alcohol withdrawal syndrome: Another piece of the puzzle. Critical Care Medicine. 2014;42(5):1298-9. Abbruscato A, Baron J, Wang S, DeMuro J. Use of dexmedetomidine for treatment of alcohol withdrawal syndrome: Review of the current literature. OA Alcohol. 2014;2(2). Lucyk S, Hoffman RS, Nelson LS. Dexmedetomidine in addition to benzodiazepine-based sedation in patients with alcohol withdrawal delirium. Eur J Emerg Med. 21. England2014. p. 389-90. Slim J. A randomized, double-blind, placebo-controlled dose range study of dexmedetomidine as adjunctive therapy for alcohol withdrawal. Journal of Emergency Medicine. 2014;47(2):254. Demuro JP, Wirkowski E, Hanna AF. Response to "benzodiazepine misadventure in acute alcohol withdrawal: The transition from delirium tremens to ICU delirium". Journal of Anesthesia. 2013;27(1):137-8. Johnson MT, Yamanaka TT, Fraidenburg DR, Kane SP. Benzodiazepine misadventure in acute alcohol withdrawal: The transition from delirium tremens to ICU delirium. Journal of Anesthesia. 2013;27(1):135-6. Lizotte RJ, Kappes JA, Bartel BJ, Hayes KM, Lesselyoung VL. Evaluating the effects of dexmedetomidine compared to propofol as adjunctive therapy in patients with alcohol withdrawal. Clin Pharmacol. 2014;6:171-7. Hodgman T, Teevan C. Use of adjunctive dexmedetomidine for alcohol withdrawal in a large community ICU. Critical Care Medicine. 2013;41(12):A237. Smith A, Cwik J, Stone A. Dexmedetomidine as an adjunctive agent in the management of alcohol withdrawal in critically ill. Critical Care Medicine. 2013;41(12):A218-A9. Amusina O, Zell-Kanter M, Clouse A, Leikin JB. Dexmedetomidine as an adjunct in patients undergoing treatment for ethanol withdrawal in the critical care setting. Clin Toxicology. 2012;50(7):579-80. Foster C, Mueller S, Vanderweide L, Kiser T, Fish D, MacLaren R. Addition of dexmedetomidine to the standard of care for severe alcohol withdrawal. Crit Care Med. 2012;40(12):23. Grelle JL, King SE, Haase KK. Dexmedetomidine as adjunctive therapy in alcohol withdrawal syndrome patients in an intensive care unit. Pharmacotherapy. 2012;32(10):e191. Vijayakumar DG, Kumaran SS, Jena N. Dexmedetomidine as an adjunct in patients undergoing treatment for ethanol withdrawal in the critical care setting. Indian Journal of Crit Care Med. 2014;18:S62. Muzyk AJ, Revollo JY, Rivelli SK. The use of dexmedetomidine in alcohol withdrawal. J Neuropsychiatry Clin Neurosci. 24. United States2012. p. E45-6. Tamada N, Matsuzaki S, Matsuda T, Yamaguchi Y. Use of dexmedetomidine in a critically ill patient with hyperactive delirium: A case report. Masui. 2012;61(10):1108-11. Dailey RW, Leatherman JW, Sprenkle MD. Dexmedetomidine in the management of alcohol withdrawal and alcohol withdrawal delirium. Am J Respir Crit Care Med. 2011;183(1). Peterson LK, Wiegand T. Dexmedetomidine as effective adjunctive agent in the treatment of a patient with severe alcohol and benzodiazepine withdrawal. Clin Toxicology. 2011;49(6):543. Darrouj J, Puri N, Prince E, Lomonaco A, Spevetz A, Gerber DR. Dexmedetomidine infusion as adjunctive therapy to benzodiazepines for acute alcohol withdrawal. Ann Pharmacoth. 2008;42(11):1703-5. Bamgbade OA. Dexmedetomidine for peri-operative sedation and analgesia in alcohol addiction. Anaesthesia. 2006 Mar;61(3):299-300 Rovasalo A, Tohmo H, Aantaa R, Kettunen E, Palojoki R. Dexmedetomidine as an adjuvant in the treatment of alcohol withdrawal delirium: a case report. Gen Hosp Psychiatry. 2006 Jul-Aug;28(4):362-3. Duenas C, Serpa A, Caez C, Ortiz-Ruiz G. Dexmedetomidina como tratamiento coadyuvante en pacientes con síndrome de abstinencia por alcohol- delirium tremens. Acta Colomb Cuid Intensivo. 2011;11(2):100-2. Harris ZM, Alonso A, Kennedy TP. Adrenergic Inhibition with Dexmedetomidine to Treat Stress Cardiomyopathy during Alcohol Withdrawal: A Case Report and Literature Review. Case Rep Crit Care. 2016;2016:9. Clark BJ, Moss M, Overdier KH, Keniston A, Burnham EL, Doody M, et al. Dexmedetomidine as an adjunctive therapy for critically ill patients with severe alcohol withdrawal syndrome. Am J Respir Crit Care Med. 2012;185. Mazanikov M, Udd M, Kylanpaa L, Mustonen H, Lindstrom O, Halttunen J, et al. Dexmedetomidine impairs success of patient-controlled sedation in alcoholics during ERCP: a randomized, double-blind, placebo-controlled study. Surg Endosc. 2013;27(6):2163-8. Leong C, Rachwalski E, Lizza B, Cooper C. Retrospective comparison of alpha-2 agonists for alcohol withdrawal in the MICU. Crit Care Med. 2015;43(12):138. Brink H, Peitz G, Klepser D, Olsen K. Comparison of dexmedetomidine as adjunct therapy to benzodiazepines vs. Standard benzodiazepine therapy in treatment of alcohol withdrawal syndrome. Crit Care Med. 2012;40(12):259-60. Au T, Malesker M, Hilleman D, Walters R, Wichman C, Morrow L. A retrospective analysis of dexmedetomidine use for alcohol withdrawal syndrome in critical care patients. Chest. 2014;146(4). Kachalia A, Kachalia K, Nagalli S, Lopez R, Rizzo V. Analysis of safety and efficacy of dexmedetomidine as adjunctive therapy for alcohol withdrawal in intensive care unit. Am J Respir Crit Care Med. 2014;189. Crispo AL, Daley MJ, Pepin JL, Harford PH, Brown CV. Comparison of clinical outcomes in nonintubated patients with severe alcohol withdrawal syndrome treated with continuous-infusion sedatives: dexmedetomidine versus benzodiazepines. Pharmacotherapy. 2014;34(9):910-7. VanderWeide LA, Foster CJ, MacLaren R, Kiser TH, Fish DN, Mueller SW. Evaluation of Early Dexmedetomidine Addition to the Standard of Care for Severe Alcohol Withdrawal in the ICU: A Retrospective Controlled Cohort Study. J Intensive Care Med. 2016;31(3):198-204. Ferreira JA, Wieruszewski PM, Cunningham DW, Davidson KE, Weisberg SF. Approach to the Complicated Alcohol Withdrawal Patient. J Intensive Care Med. 2015. Wong A, Benedict NJ, Kane-Gill SL. Multicenter evaluation of pharmacologic management and outcomes associated with severe resistant alcohol withdrawal. Jof Crit Care. 2015;30(2):405-9. Mirijello A, D'Angelo C, Ferrulli A, Vassallo G, Antonelli M, Caputo F, et al. Identification and management of alcohol withdrawal syndrome. Drugs. 2015;75(4):353-65. TEME |
| Palavras-Chave | #616.861 #Delirio por Abstinencia Alcohólica #Dexmedetomidina #Dexmedetomidine #Alcohol Use Disorder #Alcoholism #Alcohol #benzodiazepines #Intensive care #Alcohol withdrawal syndrome |
| Tipo |
info:eu-repo/semantics/bachelorThesis info:eu-repo/semantics/acceptedVersion |
