Alcohol withdrawal syndrome (AWS) is a complex neurologic disorder that develops after an acute reduction in or cessation of chronic alcohol consumption that alters neurotransmitter conduction. The incidence of AWS in the intensive care unit (ICU) varies, but has been associated with poor outcomes.

This is primarily driven by downregulation of gamma-aminobutyric acid (GABA) leading to autonomic excitability and psychomotor agitation. No clinical assessment tools have been validated to assess for AWS in the intensive care unit, particularly for patients requiring mechanical ventilation.

The Clinical Institute Withdrawal Assessment for Alcohol Scale, Revised, may be considered to gauge the extent of withdrawal, but is not particular with acute presentations in this population. Symptom-triggered use of GABA agonist such as benzodiazepines remains the mainstay of pharmacotherapeutic intervention.

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