Nicotine replacement therapy in critically ill patients

A prospective observational cohort study

Rodrigo Cartin-Ceba, David Oman Warner, James Taylor Hays, Bekele Afessa

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Objective: Smokers admitted to the intensive care unit may receive nicotine replacement therapy to prevent nicotine withdrawal. However, recent studies have questioned the safety of this practice. The objective of this study was to determine the impact of nicotine replacement therapy on the outcomes of critically ill patients. Design: Prospective observational cohort. Setting: The medical intensive care unit of a tertiary academic hospital. Patients: Active smokers admitted to the intensive care unit. Interventions: None. Measurements and Main Results: After excluding 2,411 patients who did not meet the study inclusion criteria, 330 were included in the study, of which 174 patients received and 156 did not receive nicotine replacement therapy. There were no significant differences in the unadjusted hospital mortality between the two groups: 14 patients (7.8%; 95% confidence interval, 4-12) died in the nicotine replacement therapy group as compared with ten patients (6.3%; 95% confidence interval, 2.6-10.3) in the nonnicotine replacement therapy group (p = .59). After adjusting for severity of illness and propensity score for administration of nicotine replacement therapy on intensive care unit admission, nicotine replacement therapy was not associated with increased hospital mortality (odds ratio, 1.4; 95% confidence interval, 0.5-3.9; p = .51). Limitations: Single-center observational study. Conclusions: Nicotine replacement therapy is not associated with increased hospital mortality in critically ill patients. However, we were not able to demonstrate any clinically significant benefit from its use in the intensive care unit setting.

Original languageEnglish (US)
Pages (from-to)1635-1640
Number of pages6
JournalCritical Care Medicine
Volume39
Issue number7
DOIs
StatePublished - Jul 2011

Fingerprint

Nicotine
Critical Illness
Observational Studies
Cohort Studies
Intensive Care Units
Hospital Mortality
Confidence Intervals
Therapeutics
Group Psychotherapy
Propensity Score
Tertiary Care Centers
Odds Ratio
Safety

Keywords

  • APACHE
  • intensive care
  • length of stay
  • mortality
  • nicotine
  • smoking

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Nicotine replacement therapy in critically ill patients : A prospective observational cohort study. / Cartin-Ceba, Rodrigo; Warner, David Oman; Hays, James Taylor; Afessa, Bekele.

In: Critical Care Medicine, Vol. 39, No. 7, 07.2011, p. 1635-1640.

Research output: Contribution to journalArticle

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abstract = "Objective: Smokers admitted to the intensive care unit may receive nicotine replacement therapy to prevent nicotine withdrawal. However, recent studies have questioned the safety of this practice. The objective of this study was to determine the impact of nicotine replacement therapy on the outcomes of critically ill patients. Design: Prospective observational cohort. Setting: The medical intensive care unit of a tertiary academic hospital. Patients: Active smokers admitted to the intensive care unit. Interventions: None. Measurements and Main Results: After excluding 2,411 patients who did not meet the study inclusion criteria, 330 were included in the study, of which 174 patients received and 156 did not receive nicotine replacement therapy. There were no significant differences in the unadjusted hospital mortality between the two groups: 14 patients (7.8{\%}; 95{\%} confidence interval, 4-12) died in the nicotine replacement therapy group as compared with ten patients (6.3{\%}; 95{\%} confidence interval, 2.6-10.3) in the nonnicotine replacement therapy group (p = .59). After adjusting for severity of illness and propensity score for administration of nicotine replacement therapy on intensive care unit admission, nicotine replacement therapy was not associated with increased hospital mortality (odds ratio, 1.4; 95{\%} confidence interval, 0.5-3.9; p = .51). Limitations: Single-center observational study. Conclusions: Nicotine replacement therapy is not associated with increased hospital mortality in critically ill patients. However, we were not able to demonstrate any clinically significant benefit from its use in the intensive care unit setting.",
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