%0 Journal Article
%T Pneumonia is a common and early complication of the Severe Alcohol Withdrawal Syndrome (SAWS).
%A Carlson RW
%A Girgla N
%A Davis J
%A Moradi A
%A Cooper T
%J Heart Lung
%V 55
%N 0
%D Sep-Oct 2022
%M 35468360
%F 3.149
%R 10.1016/j.hrtlng.2022.04.001
%X Pneumonia (PNA) may complicate the Severe Alcohol Withdrawal Syndrome (SAWS), with ICU admission, mechanical ventilation (MV), prolonged length of stay (LOS), and adverse events.<BR>To examine the onset, features and courses of PNA in patients with SAWS to aid management.<BR>A 33 month contiguous review of SAWS and PNA was conducted at an urban public hospital.<BR>There were 279 episodes of Alcohol Withdrawal Syndrome (AWS) among 255 patients. Males predominated (91%) with a mean age of 45.8 years (range 23-73), of whom 31% (87/279) developed SAWS with ICU management. Direct ICU admission occurred for 62 patients; 25 were transferred for delirium, seizures, escalating sedation, PNA or other complications. PNA was identified for 34 ICU direct admissions and 13 ward patients. Ten transfers to the ICU also developed PNA for an ICU total of 44/87 (51%), of whom 82% (36/44) required MV. Another 10 ICU patients without PNA received MV for high dose sedation or respiratory failure. Most ICU patients (72/87 (83%)), including all with MV, required IV infusion of sedation. MV prolonged LOS, but LOS for PNA with MV was similar to all MV. ICU transfers had longer LOS with greater use of MV than direct admits (p<0.05). PNA was identified before ICU admission or transfer for 73% (32/44 (p<0.05)), and usually before intubation. Most PNA was Community Acquired Pneumonia (CAP) with P. Pneumoniae frequently cultured.<BR>PNA with SAWS is predominately CAP and occurs early. Focused ICU admission with respiratory support are priorities of initial management.