Inpatient alcohol withdrawal syndrome

R Monte-Secades; R Rabuñal-Rey; H Guerrero-Sande

doi:10.1016/j.rce.2014.11.013

Inpatient alcohol withdrawal syndrome

Rev Clin Esp (Barc). 2015 Mar;215(2):107-16. doi: 10.1016/j.rce.2014.11.013. Epub 2015 Jan 2.

[Article in English, Spanish]

Authors

R Monte-Secades¹, R Rabuñal-Rey², H Guerrero-Sande²

Affiliations

¹ Servicio de Medicina Interna, Hospital Universitario Lucus Augusti, Lugo, España; Grupo de Alcohol y Alcoholismo. SEMI. Electronic address: rafael.monte.secades@sergas.es.
² Servicio de Medicina Interna, Hospital Universitario Lucus Augusti, Lugo, España; Grupo de Alcohol y Alcoholismo. SEMI.

PMID: 25559647
DOI: 10.1016/j.rce.2014.11.013

Abstract

A 55-year-old man was admitted for a femur fracture; an alcohol fetor was noted on admission. The following day, the patient began to experience tremors and nervousness. Intravenous haloperidol was administered. Shortly afterwards, the patient experienced two generalized seizures and then began to experience delirium and uncontrollable agitation. The patient was diagnosed with alcohol withdrawal syndrome; high doses of intravenous midazolam were prescribed and infused. A few hours later, the patient presented signs of respiratory depression, requiring a transfer to the intensive care unit. After a review of the medical history, it was determined that the patient had been admitted on 3 previous occasions due to alcohol withdrawal and had progressed to delirium tremens after experiencing seizures. Can the risk of alcohol withdrawal syndrome and the need for prophylactic treatment be assessed on admission? Were appropriate monitoring and treatment measures employed? Would it have been possible to change his outcome?

Keywords: Abstinencia alcohólica; Alcohol withdrawal; Alcohol withdrawal delirium; Delirio por abstinencia alcohólica; Inpatients; Pacientes hospitalizados; Tratamiento; Treatment.