Study: Caffeine and Nicotine Withdrawal May Be Under-Recognized in the ICU

Be sure to tell your doctors and nurses about your smoking and coffee drinking

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Photo by Mike Kenneally on Unsplash

It is a common occurrence in the ICU: patients admitted with critical illness can become increasingly agitated, requiring high doses of sedative medications to protect them from self-harm. Many times, it is due to withdrawal from alcohol, and a careful history about alcohol — as well as tobacco — use is an essential part of taking care of patients admitted to the ICU. New research indicates that caffeine withdrawal can be important as well:

The research findings, presented in early June at the European Society of Anesthesiology conference, were eye-opening:

And so, it is very important for clinicians taking care of patients in the ICU, such as myself, to ascertain how much coffee a patient consumes on a daily basis. This is not typically something we think of when we take care of patients in the ICU, and this new research indicates that we should start doing so. Furthermore, since healthcare is a team effort, if we are admitted as patients in the ICU, we should notify the doctors and nurses taking care of us about how much coffee we drink on a daily basis.

For nicotine withdrawal, we routinely will give our patients nicotine patches to treat possible nicotine withdrawal, and this research suggests this is the right thing to do. For caffeine withdrawal, however, we may not be able to do much about caffeine withdrawal, especially if a patient is on a ventilator and cannot take anything by mouth.

There is IV caffeine, believe it or not, but there is very little research on its effectiveness in the ICU. That said, if someone drinks a lot of coffee and has significant agitation in the ICU on a ventilator, perhaps giving coffee may help. It is pretty harmless, and it may prevent the administration of sedative medications that can prolong one’s stay on a ventilator. Definitely some food for thought…

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NY Times featured Pulmonary and Critical Care Specialist | Physician Leader | Author and Blogger | His latest book is “Code Blue,” a medical thriller.

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