Safety and Monitoring During Pediatric ICU Sedation

Author(s):  
Kaitlin M. Best
Keyword(s):  
2021 ◽  
pp. 089719002110215
Author(s):  
Sara A. Atyia ◽  
Keaton S. Smetana ◽  
Minh C. Tong ◽  
Molly J. Thompson ◽  
Kari M. Cape ◽  
...  

Background: Dexmedetomidine is a highly selective α2-adrenoreceptor agonist that produces dose-dependent sedation, anxiolysis, and analgesia without respiratory depression. Due to these ideal sedative properties, there has been increased interest in utilizing dexmedetomidine as a first-line sedative for critically ill patients requiring light sedation. Objective: To evaluate the ability to achieve goal intensive care unit (ICU) sedation before and after an institutional change of dosing from actual (ABW) to adjusted (AdjBW) body weight in obese patients on dexmedetomidine. Methods: This study included patients ≥ 18 years old, admitted to a surgical or medical ICU, required dexmedetomidine for at least 8 hours as a single continuous infusion sedative, and weighed ≥ 120% of ideal body weight. Percentage of RASS measurements within goal range (−1 to +1) during the first 48 hours after initiation of dexmedetomidine as the sole sedative agent or until discontinuation dosed on ABW compared to AdjBW was evaluated. Results: 100 patients were included in the ABW cohort and 100 in the AdjBW cohort. The median dosing weight was significantly higher in the ABW group (95.9 [78.9-119.5] vs 82.2 [72.1-89.8] kg; p = 0.001). There was no statistical difference in percent of RASS measurements in goal range (61.5% vs 69.6%, p = 0.267) in patients that received dexmedetomidine dosed based on ABW versus AdjBW. Conclusion: Dosing dexmedetomidine using AdjBW in obese critically ill patients for ongoing ICU sedation resulted in no statistical difference in the percent of RASS measurements within goal when compared to ABW dosing. Further studies are warranted.


Children ◽  
2021 ◽  
Vol 8 (2) ◽  
pp. 59
Author(s):  
Andrew Kampfschulte ◽  
Matthew Oram ◽  
Alejandra M. Escobar Vasco ◽  
Brittany Essenmacher ◽  
Amy Herbig ◽  
...  

Suicide frequency has tripled for some pediatric age groups over the last decade, of which, serious attempts result in pediatric intensive care unit (PICU) admissions. We paired clinical, aggregate geospatial, and temporal demographics to understand local community variables to determine if epidemiological patterns emerge that associate with risk for PICU admission. Data were extracted at an urban, high-volume, quaternary care facility from January 2011 to December 2017 via ICD 10 codes associated with suicide. Clinical, socioeconomic, geographical, and temporal variables were reviewed. In total, 1036 patients over the age of 9 were included, of which n = 161 were PICU admissions. Females represented higher proportions of all suicide-related hospital admissions (67.9%). Looking at race/ethnicity, PICU admissions were largely Caucasian (83.2%); Blacks and Hispanics had lower odds of PICU admissions (OR: 0.49; 0.17, respectively). PICU-admitted patients were older (16.0 vs. 15.5; p = 0.0001), with lower basal metabolic index (23.0 vs. 22.0; p = 0.0013), and presented in summer months (OR: 1.51, p = 0.044). Time-series decomposition showed seasonal peaks in June and August. Local regions outside the city limits identified higher numbers of PICU admissions. PICUs serve discrete geographical regions and are a source of information, when paired with clinical geospatial/seasonal analyses, highlighting clinical and societal risk factors associated with PICU admissions.


2002 ◽  
Vol 30 (Supplement) ◽  
pp. A159
Author(s):  
Sheilah Smok-Pearsall
Keyword(s):  

2018 ◽  
Vol 46 (1) ◽  
pp. 628-628 ◽  
Author(s):  
Grace Arteaga ◽  
Yu Kawai ◽  
Debra Rowekamp ◽  
Gina Rohlik ◽  
Nanette Matzke ◽  
...  

2018 ◽  
Vol 46 (1) ◽  
pp. 655-655
Author(s):  
Heda Dapul ◽  
Tiffany Folks ◽  
Mary Rose ◽  
Stacy Pantor ◽  
Joelle Pierre-Louis ◽  
...  

2021 ◽  
pp. respcare.08494
Author(s):  
Jeremy M Loberger ◽  
Ryan M Jones ◽  
Amy M Hill ◽  
Shannon E O’Sheal ◽  
Christy L Thomas ◽  
...  
Keyword(s):  

2015 ◽  
Author(s):  
Sujoy Banik ◽  
Ashish Bindra ◽  
Varun Jain ◽  
Keshav Goyal ◽  
Niraj Kumar ◽  
...  
Keyword(s):  

2018 ◽  
Vol 71 (suppl 3) ◽  
pp. 1420-1427
Author(s):  
Letícia Medeiros Santomé ◽  
Sandra Maria Cezar Leal ◽  
Joel Rolim Mancia ◽  
Antônio Marcos Freire Gomes

ABSRACT Objective: to characterize children hospitalized due to violence in a pediatric ICU in 2011; to relate violence and the mechanisms of trauma with death; to know the contextualization of violence, from the records in the medical records. Method: retrospective cohort, performed in a first aid hospital, Porto Alegre city, in the records of 22 children hospitalized in the ICU due to violence. Quantitative analysis was performed by absolute and relative frequency rates, chi-square and relative risk. Results: 54.5% were boys, 81.8% were white and 50% were up to three years old. Physical violence 50% and neglect 36.4%, family of children (77.3%), highlighting the mother (35.3%). Mechanisms of aggression: fall (22.7%), burns (18.2%). Burns were at high risk for death. Discharge to go home after ICU admission (59.1%). Conclusion: It is considered that the characterization of the cases of violence reflects the complexity of the theme, mainly, in face of the life histories that surround each case of children hospitalized by this aggravation.


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