Critical Care Aspects of Alcohol Abuse

Ibrahim Al-Sanouri MD; Matthew Dikin MD; Ayman O. Soubani MD

Disclosures

South Med J. 2005;98(3):372-381. 

In This Article

Abstract and Introduction

Abstract

The authors reviewed MEDLINE and references of major articles in the published literature over the last 30 years regarding the complications of alcohol abuse and discuss the critical care aspects of alcohol abuse. This article discusses the severe medical conditions associated with alcohol abuse that lead to admission to the medical intensive care unit. The clinical manifestations, pathophysiology, diagnostic studies, and management of these conditions are discussed in detail.

Introduction

Alcohol abuse is defined as the regular and excessive use of alcohol that is associated with concomitant physical, emotional, and social problems. During the 20th century, alcohol abuse has emerged as a major problem with global health implications. In Westernized countries, more than 50% of adults can be classified as alcohol consumers. For most of these people, drinking is a safe, pleasurable experience with minimal health consequences. However, about 10% of alcohol consumers will at some point experience serious health problems related to their drinking habit.[1] Although difficult to accurately quantify, in the United States, approximately 11 to 15 million people report heavy alcohol intake.[2,3] The costs of medical complications related to alcohol abuse in the United States are also astonishing, and are estimated to be nearly $100 billion per year.[2,3] Moreover, tobacco and alcohol account for approximately three quarters of the substance abuse-related intensive care admissions and costs. Similar statistics are reported in other parts of the world.[4]

Alcohol-related medical problems in the medical intensive care unit (MICU) involve almost every system, including the neurologic, respiratory, gastrointestinal, cardiovascular, and renal systems (Table 1). The frequency of adult surgical and medical ICU admissions related to substance abuse was determined at a large community trauma and tertiary referral hospital. It was found that 9% of ICU admissions were alcohol related, generating 13% of costs. It was also noted that ICU admissions in patients with a history of alcohol abuse were longer and more costly than admissions not associated with alcohol abuse.[5]

This review will discuss the alcohol emergencies that require prompt attention, as most of these complications are reversible if they are recognized early and treated properly.

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