Our aim is to compare outcomes of patients with benzodiazepine-refractory alcohol withdrawal syndrome who are treated with either a phenobarbital-based or a lorazepam based protocol.
* This study is a prospective, open-label, randomized, controlled trial. * The electronic medical record will be used to identify patients who have a diagnosis of alcohol withdrawal or are receiving alcohol withdrawal. Subjects who are anticipated to meet inclusion criteria will be pre-consented for the study using an informed consent process. see informed consent form. * Subjects will not be enrolled and randomized until they have met inclusion criteria. * If a patient meets criteria, but is deemed non-decisional or unable to give consent, the patient's medical decision maker will undergo the informed consent process. * After enrollment, participants will be randomized to either the control group (lorazepam-based therapy) or the study group (phenobarbital-based therapy) * Personnel unassociated with patient screening, enrollment, or follow up will create the allocation sequence and will use a random, computerized number generator. The allocation sequence will then be transferred to sequentially numbered, opaque envelopes for purposes of allocation concealment. These sequentially numbered envelopes, which are blinded to clinical trial coordinators/physicians, will be handed out in order as patients are enrolled. Clinical trial coordinators/physicians will verify treatment eligibility and informed consent before opening the envelope to obtain the treatment assignment. * The study group will be placed on the phenobarbital-based protocol as described below in procedures. The control group will be placed on the lorazepam-based protocol, also listed below in procedures. * All medications in the study are FDA approved. No investigational medicines will be used. * Data will be collected on each participant as noted below in measurements. * The data will be analyzed and published as noted above in the statistical analysis plan and data use and management section.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
142
Phenobarbital loading dose followed by a taper will be given to control acute alcohol withdrawal syndrome
Ativan will be given according to our institutional alcohol withdrawal protocol to control acute alcohol withdrawal syndrome
OSF Saint Francis Medical Center
Peoria, Illinois, United States
RECRUITINGICU length of stay
number of days in the intensive care unit
Time frame: study completion, up to 18 months
Hospital length of stay
number of days in the hospital
Time frame: Study completion, up to 18 months
30-day readmission
rate of readmission of patients within 30 days for any cause
Time frame: study complettion, up to 18 months
mortality
number of deaths
Time frame: Study completion, up to 18 months
Intubation
rate of endotracheal intubation
Time frame: study completion, up to 18 months
Hospitalization cost
Cost of index hospital stay
Time frame: Study completion, up to 18 months
Lorazepam use
total lorazepam use in mg during the entire hospital stay
Time frame: Study completion, up to 18 months
dexmedetomidine use
total dexmedetomidine used in mcg during the entire hospital stay
Time frame: Study completion, up to 18 months
propofol use
total propofol used in mg during the entire hospital stay
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Time frame: Study completion, up to 18 months