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With Nicotine Replacement Therapy, ICU Patients are at higher Risk of Death

November 1, 2006

NRTs or nicotine replacement therapies like nicotine patch, nicotine gum etc. which are used to combat nicotine withdrawal actually increase the risk of death of smoking patients admitted to Intensive Care Unit (ICU).

This fact was presented in a new study in CHEST 2006, the 72nd annual international scientific assembly of the American College of Chest Physicians (ACCP). In this study, the researchers found that the patients who were on NRT while they were admitted to ICU, had a higher risk of death compared to those who did not take the nicotine supplements.

The nicotine withdrawal symptoms were worsening the diagnosis of the patients in ICU, so they were given NRT to control their nicotine cravings.

According to the lead researcher Amy Lee, MD, Mayo Clinic College of Medicine, Minneapolis , MN , the hemo-dynamic effects of nicotine increases the heart rate and systematic arterial blood pressure as well as constriction of the coronary arteries. These effects are detrimental in critically ill patients in ICU.

The medical records of 112 smoking patients admitted to the ICU were reviewed by Lee and colleagues. The patients were smokers and received NRT during their stay. The researchers examined the safety of NRT in the ICU, compared the patient outcomes between the NRT group and a control group.

While, among the patients receiving NRT, 18 died, in the control group only 3 deaths occurred. The hospital death rate was 21.4% for the NRT group, in contrast of 5.4% in the control group. Moreover, NRT was found to be an independent risk factor for mortality.

At the same time, researchers warn about determining the real cause of symptoms that mimic nicotine withdrawal in seriously ill patients. They say that minimizing the effects of nicotine withdrawal in serious patients who smoke can throw challenge to the ICU team.

However, this finding calls for additional research on the effects of nicotine replacement therapy on patients in ICU and looking for better alternative to control nicotine cravings.


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