Suggested criteria for ICU admission of patients with alcohol withdrawal

Age >65

Cardiac disease (heart failure, arrhythmia, angina, myocardial ischemia, recent myocardial infarction)

Hemodynamic instability

Marked acid-base disturbances

Severe electrolyte abnormalities (hypokalemia, hypophosphatemia, hypomagnesemia, hypocalcemia)

Respiratory insufficiency (hypoxemia, hypercapnia, severe hypocapnia, pneumonia, asthma, COPD)

Potentially serious infections (wounds, pneumonia, trauma, urinary tract infection)

Signs of gastrointestinal pathology (pancreatitis, GI bleeding, hepatic insufficiency, suspected peritonitis)

Persistent hyperthermia (T >39°C [103°F])

Evidence of rhabdomyolysis

Renal insufficiency

History of prior alcohol withdrawal complications (eg, delirium tremens, alcohol withdrawal seizures)

Need for frequent or high doses of sedatives or an intravenous infusion to control symptoms

Withdrawal despite an elevated ethanol concentration

COPD: chronic obstructive pulmonary disease; GI: gastrointestinal; ICU: intensive care unit.

Adapted from Carlson RW, Keske B, Cortez D. Alcohol withdrawal syndrome: alleviating symptoms, preventing progression. J Crit Illness 1998; 13:311.

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