A Bad Mix: Nicotine Withdrawal and ICU Patients

As all smokers who tried to quit and failed must know, relinquishing the habit is almost never an easy task. Most people set up various schedules for dropping cigarettes, promising themselves rewards, or replacing smoking with another, less harmful habit. Even then, only a part of all those who are trying to quit manage to do so. But the situation becomes bleak in the case of patients in intensive care units (ICU), who are forced to quit without their will.

Those who spend many days confined to bed cannot go out for a smoke without endangering their life. Nevertheless, withdrawal symptoms set in, and a new scientific study shows that they can have repercussions on their health and recovery process. The paper indicates that one of the most common things that happen in these scenarios is that the patients begin exhibiting signs of nervous agitation, which in turn jeopardizes the conditions they need to heal properly. Sutures, for example, may become loose, and even rip apart, due to tremors and other such symptoms.

The team of experts that conducted the new investigation determined that smokers who were being forced to quit de to the nature of their condition, or of the treatment they were taking, were a lot more likely than non-smokers to engage in behaviors dangerous to themselves. The researchers say that some of these actions included the accidental removing of various tubes and catheters, which are used in ICU rooms to supply patients with nutrients. More smokers required additional sedation, analgesic or anti-psychotic medication, and some of them even needed physical restraints.

The study, however, points at some therapies that could alleviate these symptoms. “NRT [nicotine replacement therapy] remains a controversial topic in intensive care and has been associated with mortality. Due to the serious consequences of withdrawal-induced agitation, including sedation and physical restraint, we suggest that the use of nicotine replacement therapy should be tested by a well-designed, randomized controlled clinical trial in the ICU setting,” says team leader Damien du Cheyron, who is based at the Caen University Hospital, in France.

“Agitation was significantly more common in smokers than in non-smokers. These results suggest the need to be aware of nicotine withdrawal syndrome in critically ill patients, and support the need for improved strategies to prevent agitation or treat it earlier,” he adds. Details of his group's investigations appear in the latest issue of BioMed Central's open-access scientific journal Critical Care, e! Science News reports.