Clinical effects of reported synthetic cannabinoid exposure in patients admitted to the intensive care unit.

MedStar author(s):
Citation: American Journal of Emergency Medicine. 37(6):1060-1064, 2019 Jun.PMID: 30146395Institution: MedStar Washington Hospital CenterDepartment: Emergency Medicine | Medicine/Pulmonary-Critical CareForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Cannabinoids/ae [Adverse Effects] | *Synthetic Drugs/ae [Adverse Effects] | Adult | Female | Hospitalization/sn [Statistics & Numerical Data] | Humans | Intensive Care Units/og [Organization & Administration] | Intensive Care Units/sn [Statistics & Numerical Data] | Length of Stay/sn [Statistics & Numerical Data] | Male | Middle Aged | Pulmonary Edema/et [Etiology] | Retrospective Studies | Severity of Illness Index | Tachycardia/et [Etiology]Year: 2019Local holdings: Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006ISSN:
  • 0735-6757
Name of journal: The American journal of emergency medicineAbstract: CONCLUSIONS: Patients admitted to ICU after SC exposure exhibit significant organ dysfunction, particularly neurologic and respiratory. Prognosis is good with supportive care.Copyright (c) 2018. Published by Elsevier Inc.DESIGN: Retrospective case series of patients admitted to medical or cardiac ICU.MEASUREMENTS: Demographics, Sequential Organ Failure Assessment (SOFA) scores, and clinical parameters documenting the effects and hospital course.OBJECTIVE: To characterize the clinical presentation and hospital course of patients with reported synthetic cannabinoid (SC) exposure requiring Intensive Care Unit (ICU) admission.PARTICIPANTS: Adults >=18years old admitted from the emergency department (ED) in 2015.RESULTS: 23 patients met inclusion criteria. Median age was 47years (interquartile range [IQR], 32-54); 83% male; 78% black. Patients were generally tachycardic (HR>100), (65%) and hypertensive (SBP>140), (65%) on admission. The initial chest X-ray and ECG were abnormal in 43% and 68% of patients, respectively. Pulmonary edema and tachycardia were the most common findings. Head CT imaging was abnormal in 5% of patients. Troponin was elevated >1.0ng/ml in 3 of 19 patients (16%). Other exposures detected on admission were marijuana (30%), alcohol (30%), and benzodiazepines (26%). The median SOFA score was 6 on admission and decreased over the next 3days. SOFA scores were primarily driven by altered neurologic status and respiratory failure. 91% required mechanical ventilation, 30% had seizures as a part of presentation, 18% required vasopressors, and 5% needed dialysis. Median hospital and ICU lengths of stay were 2.6 (IQR 1.4-3.5) and 1.6 (IQR 0.9-2.5) days, respectively. The median hospital charge was SETTING: Urban tertiary care center.All authors: Abbasi A, Goyal M, Mazer-Amirshahi M, Tatusov MFiscal year: FY2019Digital Object Identifier: Date added to catalog: 2018-08-31
Holdings
Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 30146395 Available 30146395

Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006

CONCLUSIONS: Patients admitted to ICU after SC exposure exhibit significant organ dysfunction, particularly neurologic and respiratory. Prognosis is good with supportive care.

Copyright (c) 2018. Published by Elsevier Inc.

DESIGN: Retrospective case series of patients admitted to medical or cardiac ICU.

MEASUREMENTS: Demographics, Sequential Organ Failure Assessment (SOFA) scores, and clinical parameters documenting the effects and hospital course.

OBJECTIVE: To characterize the clinical presentation and hospital course of patients with reported synthetic cannabinoid (SC) exposure requiring Intensive Care Unit (ICU) admission.

PARTICIPANTS: Adults >=18years old admitted from the emergency department (ED) in 2015.

RESULTS: 23 patients met inclusion criteria. Median age was 47years (interquartile range [IQR], 32-54); 83% male; 78% black. Patients were generally tachycardic (HR>100), (65%) and hypertensive (SBP>140), (65%) on admission. The initial chest X-ray and ECG were abnormal in 43% and 68% of patients, respectively. Pulmonary edema and tachycardia were the most common findings. Head CT imaging was abnormal in 5% of patients. Troponin was elevated >1.0ng/ml in 3 of 19 patients (16%). Other exposures detected on admission were marijuana (30%), alcohol (30%), and benzodiazepines (26%). The median SOFA score was 6 on admission and decreased over the next 3days. SOFA scores were primarily driven by altered neurologic status and respiratory failure. 91% required mechanical ventilation, 30% had seizures as a part of presentation, 18% required vasopressors, and 5% needed dialysis. Median hospital and ICU lengths of stay were 2.6 (IQR 1.4-3.5) and 1.6 (IQR 0.9-2.5) days, respectively. The median hospital charge was 7,008. All patients survived the index hospitalization.

SETTING: Urban tertiary care center.

English

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