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. 2019 Dec 15;30(4):353-364.
doi: 10.4037/aacnacc2019267.

Opioid and Benzodiazepine Iatrogenic Withdrawal Syndrome in Patients in the Intensive Care Unit

Carmen Mabel Arroyo-Novoa  1 , Milagros I Figueroa-Ramos  1 , Kathleen A Puntillo  1
Affiliations

Opioid and Benzodiazepine Iatrogenic Withdrawal Syndrome in Patients in the Intensive Care Unit

Carmen Mabel Arroyo-Novoa et al. AACN Adv Crit Care. .

Abstract

Iatrogenic withdrawal syndrome is an increasingly recognized issue among adult patients in the intensive care unit. The prolonged use of opioids and benzodiazepines during the intensive care unit stay and preexisting disorders associated with their use put patients at risk of developing iatrogenic withdrawal syndrome. Although research to date is scant regarding iatrogenic withdrawal syndrome in adult patients in the intensive care unit, it is important to recognize and adequately manage iatrogenic withdrawal syndrome in order to prevent possible negative outcomes during and after a patient's intensive care unit stay. This article discusses in depth 8 studies of iatrogenic withdrawal syndrome among adult patients in the intensive care unit. It also addresses important aspects of opioid and benzodiazepine iatrogenic withdrawal syndrome, including prevalence, risk factors, and assessment and considers its prevention and management.

Keywords: benzodiazepines; critical care; iatrogenic withdrawal syndrome; opioids; pain management.

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Figures

Figure 1:
Figure 1:
Categorization of patients in an intensive care unit based on prior opioid and benzodiazepine experience. BNZ indicates benzodiazepine; ICU, intensive care unit; OP, opioid.
Figure 2:
Figure 2:
Clinical approach to preventing, identifying, and treating opioid or benzodiazepine iatrogenic withdrawal syndrome in adult patients in the intensive care unit. BNZ indicates benzodiazepine; DEX, dexmedetomidine; ICU, intensive care unit; IWS, iatrogenic withdrawal syndrome; NSAIDs, nonsteroidal anti-inflammatory drugs; OP, opioid.
See this image and copyright information in PMC

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