Nicotine patches in ICU

Giving very sick patients nicotine replacement therapy may not be entirely safe, although it is sometimes given to smokers in the intensive care unit (ICU) to prevent withdrawal. A retrospective case-control analysis of this treatment in ICU patients found that it is associated with increased in-hospital mortality—20% in smokers who took the treatment versus 7% in those who did not. Treatment remained independently associated with increased mortality when severity of illness and invasive mechanical ventilation were adjusted for (Critical Care Medicine 2007;35:1517-21 doi: 10.1097/01.CCM.0000266537.86437.38).