Clinical effects of reported synthetic cannabinoid exposure in patients admitted to the intensive care unit. - 2019

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. 7,008. All patients survived the index hospitalization. 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.


English

0735-6757

10.1016/j.ajem.2018.08.048 [doi] S0735-6757(18)30686-7 [pii]


*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]


MedStar Washington Hospital Center


Emergency Medicine
Medicine/Pulmonary-Critical Care


Journal Article