Literature DB >> 31474606

Validation of the Withdrawal Assessment Tool-1 in Adult Intensive Care Patients.

Anissa Capilnean1, Amanda Martone1, Vlad A Rosu1, Patricia R Sandu1, Paul Murgoi1, Anne Julie Frenette1, David Williamson1, Annie Lecavalier1, Dev Jayaraman1, Philippe Rico1, Patrick Bellemare1, Céline Gélinas1, Marc M Perreault2.   

Abstract

BACKGROUND: The Withdrawal Assessment Tool-1 (WAT-1) has been validated for assessing iatrogenic withdrawal syndrome in critically ill children receiving mechanical ventilation, but little is known about this syndrome in critically ill adults.
OBJECTIVE: To evaluate the validity and reliability of the WAT-1 in critically ill adults.
METHODS: A prospective, observational, open-cohort pilot study of critically ill adults receiving mechanical ventilation and regular administration of opioids for at least 72 hours. Patients were assessed for withdrawal twice daily on weekdays and once daily on weekends using the WAT-1 after an opioid weaning episode. The presence of iatrogenic withdrawal syndrome was evaluated once daily using modified Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) (DSM-5) criteria. All evaluations were blinded and performed independently. The criterion validity of the WAT-1 and the interrater reliability for WAT-1 and DSM-5 evaluations were determined.
RESULTS: During 8 months, 52 adults (median age, 51.5 years) were enrolled. Eight patients (15%) had at least 1 positive assessment during their intensive care unit stay using the DSM-5, compared with 19 patients (37%) using the WAT-1. The overall sensitivity of the WAT-1 was 50%, and its specificity was 65.9%. Agreement between WAT-1 and DSM-5 assessments was poor (κ = 0.102). The interrater reliability for the WAT-1 was 89.1% and for the DSM-5 was 90.1%.
CONCLUSION: Despite showing reliability, the WAT-1 is not a valid tool for assessing the presence of iatrogenic withdrawal syndrome in adults. ©2019 American Association of Critical-Care Nurses.

Entities:  

Year:  2019        PMID: 31474606     DOI: 10.4037/ajcc2019559

Source DB:  PubMed          Journal:  Am J Crit Care        ISSN: 1062-3264            Impact factor:   2.228


  4 in total

Review 1.  Iatrogenic opioid withdrawal syndromes in adults in intensive care units: a narrative review.

Authors:  Patrice S Lamey; Dylan M Landis; Kenneth M Nugent
Journal:  J Thorac Dis       Date:  2022-06       Impact factor: 3.005

2.  Effects of a Clonidine Taper on Dexmedetomidine Use and Withdrawal in Adult Critically Ill Patients-A Pilot Study.

Authors:  Krupa Bhatt; Ashley Thompson Quan; Laura Baumgartner; Shawn Jia; Rhiannon Croci; Kathleen Puntillo; James Ramsay; Rima H Bouajram
Journal:  Crit Care Explor       Date:  2020-11-03

3.  Opioid and Benzodiazepine Iatrogenic Withdrawal Syndrome in Patients in the Intensive Care Unit.

Authors:  Carmen Mabel Arroyo-Novoa; Milagros I Figueroa-Ramos; Kathleen A Puntillo
Journal:  AACN Adv Crit Care       Date:  2019-12-15

4.  Strategies for the Prevention and Treatment of Iatrogenic Withdrawal from Opioids and Benzodiazepines in Critically Ill Neonates, Children and Adults: A Systematic Review of Clinical Studies.

Authors:  Barbara Sneyers; Marc-Alexandre Duceppe; Anne Julie Frenette; Lisa D Burry; Philippe Rico; Annie Lavoie; Céline Gélinas; Sangeeta Mehta; Maryse Dagenais; David R Williamson; Marc M Perreault
Journal:  Drugs       Date:  2020-08       Impact factor: 9.546

  4 in total

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