{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T22:10:34Z","timestamp":1778623834508,"version":"3.51.4"},"reference-count":22,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,5,19]],"date-time":"2025-05-19T00:00:00Z","timestamp":1747612800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>Benzodiazepines are a cornerstone in the treatment of alcohol withdrawal symptoms, although their use is associated with a risk of sedation leading to respiratory depression. This study describes the reasons for and frequency of Intensive Care Unit (ICU) admission, mechanical ventilation, and clinical outcomes for patients receiving symptom\u2010triggered treatment with chlordiazepoxide for alcohol withdrawal symptoms. This retrospective quality\u2010improvement study included admissions to a Danish general ICU after treatment with at least 200\u2009mg chlordiazepoxide for alcohol withdrawal symptoms within 10\u2009days before ICU admission. The primary outcome was the need for mechanical ventilation and secondary outcomes included 90\u2010day hospital\u2010 and ICU readmission and mortality. The admissions were divided into two groups: \u201cToo sedated\u201d and \u201cToo agitated\u201d depending on the reason for ICU admission. A total of 113 patients with 133 admissions were included. The most common reasons for ICU admissions were respiratory insufficiency (39%) and somnolence (39%). Invasive or non\u2010invasive mechanical ventilation was used in 71% of the ICU admissions (81% in the \u201cToo sedated\u201d and 53% in the \u201cToo agitated\u201d group, respectively). Thirty\u2010six percent of admissions were followed by readmission to the hospital and 14% by readmission to the ICU within 90\u2009days. Admissions were followed by a 21% risk of mortality at 90\u2009days in the \u201cToo sedated\u201d group, whereas no patients died within 90\u2009days in the \u201cToo agitated\u201d group. Typical presentation of ICU admission was respiratory insufficiency and somnolence after symptom\u2010triggered treatment with chlordiazepoxide for alcohol withdrawal symptoms. Mechanical ventilation was used in more than two\u2010thirds of the admitted patients, and the risk of readmission and fatal outcome was high.<\/jats:p>","DOI":"10.1111\/aas.70046","type":"journal-article","created":{"date-parts":[[2025,5,19]],"date-time":"2025-05-19T13:57:52Z","timestamp":1747663072000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Respiratory Failure Requiring Mechanical Ventilation Among Patients Receiving Chlordiazepoxide for Alcohol Withdrawal Symptoms"],"prefix":"10.1111","volume":"69","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7113-5859","authenticated-orcid":false,"given":"Nanna","family":"Reiter","sequence":"first","affiliation":[{"name":"Department of Anaesthesia and Intensive Care Copenhagen University Hospital\u2014Bispebjerg and Frederiksberg  Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helena Roed","family":"Otte","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Intensive Care Copenhagen University Hospital\u2014Bispebjerg and Frederiksberg  Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kim","family":"Dalhoff","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology Copenhagen University Hospital\u2014Bispebjerg and Frederiksberg  Copenhagen Denmark"},{"name":"Department of Clinical Medicine University of Copenhagen  Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian Aage","family":"Wamberg","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Intensive Care Copenhagen University Hospital\u2014Bispebjerg and Frederiksberg  Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tonny Studsgaard","family":"Petersen","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology Copenhagen University Hospital\u2014Bispebjerg and Frederiksberg  Copenhagen Denmark"},{"name":"Department of Clinical Medicine University of Copenhagen  Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian S.","family":"Meyhoff","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Intensive Care Copenhagen University Hospital\u2014Bispebjerg and Frederiksberg  Copenhagen Denmark"},{"name":"Department of Clinical Medicine University of Copenhagen  Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,5,19]]},"reference":[{"key":"e_1_2_9_2_1","volume-title":"Fakta om alkoholrelaterede skader og indl\u00e6ggelser i sundhedsv\u00e6senet","author":"Alkohol & Samfund","year":"2023"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.3390\/brainsci14030294"},{"key":"e_1_2_9_4_1","first-page":"1","article-title":"Alcohol Withdrawal","author":"Alexiou A.","year":"2023","journal-title":"Bmj"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.164.13.1405"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1407298"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra020617"},{"key":"e_1_2_9_8_1","unstructured":"Product Information: Chlordiazepoxide Hydroxychloride Oral Capsule Usp.Watson Laboratories Inc (2005)."},{"key":"e_1_2_9_9_1","volume-title":"Disposition of Toxic Drugs and Chemicals in Man","author":"Baselt R.","year":"2017"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/j.1875-9114.1996.tb02915.x"},{"key":"e_1_2_9_11_1","author":"Ashton C. H.","year":"2017","journal-title":"Benzodiazepine Equivalence Table"},{"issue":"1","key":"e_1_2_9_12_1","first-page":"11S","article-title":"Benzodiazepines: A Summary of Pharmacokinetic Properties","volume":"11","author":"Greenblatt D.","year":"1981","journal-title":"British Journal of Clinical Pharmacology"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/FAD.0000000000000068"},{"key":"e_1_2_9_14_1","author":"Callesen T","journal-title":"Alkoholabstinensbehandling \u2010 Visitation, Monitorering og Scoring [Internet]"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1530-0277.2007.00421.x"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRA.0000000000000354"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-019-04899-7"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/bcpt.13449"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1592\/phco.23.14.1513.31941"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.4103\/0974-2700.145422"},{"key":"e_1_2_9_21_1","first-page":"10","article-title":"Eliminating the Benzos: A Benzodiazepine\u2010Sparing Approach To Preventing and Treating Alcohol Withdrawal Syndrome","author":"McCullough M. A.","year":"2023","journal-title":"Journal of Trauma and Acute Care Surgery"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00228-023-03523-2"},{"key":"e_1_2_9_23_1","unstructured":"M.Alexandra R.Brown andJ.Jeffs Guidelines for the Management of Alcohol Dependence and Acute Withdrawal on Inpatient Wards.(2020)."}],"container-title":["Acta Anaesthesiologica Scandinavica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aas.70046","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T15:33:48Z","timestamp":1750952028000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/aas.70046"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,19]]},"references-count":22,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,7]]}},"alternative-id":["10.1111\/aas.70046"],"URL":"https:\/\/doi.org\/10.1111\/aas.70046","archive":["Portico"],"relation":{},"ISSN":["0001-5172","1399-6576"],"issn-type":[{"value":"0001-5172","type":"print"},{"value":"1399-6576","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,19]]},"assertion":[{"value":"2024-11-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-04-16","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-19","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70046"}}