Nicotine Replacement Therapy in the ICU

Hospitalized smokers are sometimes given nicotine replacement therapy (usually a transdermal patch) to prevent nicotine withdrawal symptoms. But is this practice safe in critically ill patients?

Mayo Clinic researchers identified 90 smokers who received nicotine replacement therapy during the first 24 hours of admission to a medical intensive care unit (MICU). For comparison, the researchers identified 90 control smokers (matched for age and APACHE III score) who did not receive nicotine replacement. Hospital mortality was 20% in the nicotine group and 7% in the control group — a significant difference. In analyses adjusting for severity of illness and mechanical ventilation, nicotine replacement therapy independently predicted hospital mort…