We recommend a pharmacologic regimen titrated to withdrawal symptoms in ICU patients with alcohol withdrawal syndrome. Benzodiazepines are a reasonable option; phenobarbital appears to confer some advantages in combination with benzodiazepines. Propofol and dexmedetomidine have not been rigorously tested in comparative studies of drug withdrawal treatment; their use as additional or alternative strategies for managing withdrawal syndromes in ICU patients should therefore be individualized to each patient. Insufficient data preclude recommendations as to nicotine replacement therapy and management of iatrogenic drug withdrawal in ICU patients.

Administration of a 4-hour infusion of piperacillin-tazobactam was associated with a favorable pharmacodynamic profile in patients undergoing CRRT. Concentrations associated with maximal activity were attained in our patients.

No abstract

N-acetylcysteine overdose is almost exclusively an iatrogenic event. This rare complication can lead to hemolysis or atypical hemolytic uremic syndrome. A 53-year-old Caucasian male accidentally received a two-fold N-acetylcysteine overdose that resulted in a presentation compatible with the atypical hemolytic uremic syndrome. The patient required temporary hemodialysis sessions, and he received treatment with eculizumab. This case report is the first reported N-acetylcysteine-induced atypical hemolytic uremic syndrome successfully treated with eculizumab. Clinicians should be aware of N-acetylcysteine overdose and its possible hemolytic complications.