{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T05:39:42Z","timestamp":1790141982817,"version":"4.0.1"},"reference-count":46,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2016,6,30]],"date-time":"2016-06-30T00:00:00Z","timestamp":1467244800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["accpjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacotherapy"],"published-print":{"date-parts":[[2016,7]]},"abstract":"<jats:p>\n                    Approximately 16\u201331% of patients in the intensive care unit (\n                    <jats:styled-content style=\"fixed-case\">ICU<\/jats:styled-content>\n                    ) have an alcohol use disorder and are at risk for developing alcohol withdrawal syndrome (\n                    <jats:styled-content style=\"fixed-case\">AWS<\/jats:styled-content>\n                    ). Patients admitted to the\n                    <jats:styled-content style=\"fixed-case\">ICU<\/jats:styled-content>\n                    with\n                    <jats:styled-content style=\"fixed-case\">AWS<\/jats:styled-content>\n                    have an increased hospital and\n                    <jats:styled-content style=\"fixed-case\">ICU<\/jats:styled-content>\n                    length of stay, longer duration of mechanical ventilation, higher costs, and increased mortality compared with those admitted without an alcohol\u2010related disorder. Despite the high prevalence of\n                    <jats:styled-content style=\"fixed-case\">AWS<\/jats:styled-content>\n                    among\n                    <jats:styled-content style=\"fixed-case\">ICU<\/jats:styled-content>\n                    patients, no guidelines for the recognition or management of\n                    <jats:styled-content style=\"fixed-case\">AWS<\/jats:styled-content>\n                    or delirium tremens in the critically ill currently exist, leading to tremendous variability in clinical practice. Goals of care should include immediate management of dehydration, nutritional deficits, and electrolyte derangements; relief of withdrawal symptoms; prevention of progression of symptoms; and treatment of comorbid illnesses. Symptom\u2010triggered treatment of\n                    <jats:styled-content style=\"fixed-case\">AWS<\/jats:styled-content>\n                    with \u03b3\u2010aminobutyric acid receptor agonists is the cornerstone of therapy. Benzodiazepines (BZDs) are most studied and are often the preferred first\u2010line agents due to their efficacy and safety profile. However, controversy still exists as to who should receive treatment, how to administer BZDs, and which BZD to use. Although most patients with\n                    <jats:styled-content style=\"fixed-case\">AWS<\/jats:styled-content>\n                    respond to usual doses of BZDs,\n                    <jats:styled-content style=\"fixed-case\">ICU<\/jats:styled-content>\n                    clinicians are challenged with managing BZD\u2010resistant patients. Recent literature has shown that using an early multimodal approach to managing BZD\u2010resistant patients appears beneficial in rapidly improving symptoms. This review highlights the results of recent promising studies published between 2011 and 2015 evaluating adjunctive therapies for BZD\u2010resistant alcohol withdrawal such as antiepileptics, baclofen, dexmedetomidine, ethanol, ketamine, phenobarbital, propofol, and ketamine. We provide guidance on the places in therapy for select agents for management of critically ill patients in the presence of\n                    <jats:styled-content style=\"fixed-case\">AWS<\/jats:styled-content>\n                    .\n                  <\/jats:p>","DOI":"10.1002\/phar.1770","type":"journal-article","created":{"date-parts":[[2016,5,19]],"date-time":"2016-05-19T22:20:10Z","timestamp":1463696410000},"page":"797-822","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":89,"title":["Management of Acute Alcohol Withdrawal Syndrome in Critically Ill Patients"],"prefix":"10.1002","volume":"36","author":[{"given":"Deepali","family":"Dixit","sequence":"first","affiliation":[{"name":"Ernest Mario School of Pharmacy Rutgers, The State University of New Jersey Piscataway New Jersey"},{"name":"Critical Care Robert Wood Johnson University Hospital New Brunswick New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey","family":"Endicott","sequence":"additional","affiliation":[{"name":"University of Vermont Medical Center Burlington Vermont"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Burry","sequence":"additional","affiliation":[{"name":"Mt. 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