TY  - BOOK
AU  - Goyal, Munish
AU  - Mazer-Amirshahi, Maryann
AU  - Tatusov, Michael
TI  - Clinical effects of reported synthetic cannabinoid exposure in patients admitted to the intensive care unit
SN  - 0735-6757
PY  - 2019///
KW  - *Cannabinoids/ae [Adverse Effects]
KW  - *Synthetic Drugs/ae [Adverse Effects]
KW  - Adult
KW  - Female
KW  - Hospitalization/sn [Statistics & Numerical Data]
KW  - Humans
KW  - Intensive Care Units/og [Organization & Administration]
KW  - Intensive Care Units/sn [Statistics & Numerical Data]
KW  - Length of Stay/sn [Statistics & Numerical Data]
KW  - Male
KW  - Middle Aged
KW  - Pulmonary Edema/et [Etiology]
KW  - Retrospective Studies
KW  - Severity of Illness Index
KW  - Tachycardia/et [Etiology]
KW  - MedStar Washington Hospital Center
KW  - Emergency Medicine
KW  - Medicine/Pulmonary-Critical Care
KW  - Journal Article
N1  - Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006
N2  - 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
UR  - https://dx.doi.org/10.1016/j.ajem.2018.08.048
ER  -