27 Oct 2006

Nicotine in the ICU deadly

Nicotine replacement therapy - commonly used to fight nicotine withdrawal in people trying to quit smoking - appears to increase the risk of death for critically ill smokers admitted to hospital intensive care units (ICUs), say Mayo Clinic College of Medicine researchers.

They found that smokers in the ICU who received nicotine replacement therapy (NRT) had a hospital death rate of 21.4 percent, compared with 5.4 percent for patients in a control group.

An independent risk factor
The study, which included 112 critically ill smokers, concluded that NRT was an independent risk factor for death in that group of patients.

"In some critically ill patients, the development of nicotine withdrawal symptoms can worsen their prognosis. As a result, NRT is given to active smokers in the ICU to prevent nicotine withdrawal symptoms," lead researcher Dr Amy Lee said in a prepared statement.

"The haemodynamic effects of nicotine may lead to increased heart rate, systemic arterial blood pressure, and constriction of the coronary arteries. Although these potential adverse effects of NRT have not been shown to worsen the prognosis of healthy volunteers and patients with stable coronary artery disease, they may be detrimental to critically ill patients."

The study was expected to be presented this week at the American College of Chest Physicians annual meeting, in Salt Lake City.

"Minimising the effects of nicotine withdrawal in critically ill patients who smoke can present a significant challenge to the ICU team. The findings of this study are intriguing and reinforce the need for additional research regarding the effects of nicotine replacement therapy on patients in the ICU," ACCP President Dr Mark J. Rosen said in a prepared statement. – (HealthDayNews)