scholarly journals Withdrawal symptoms in long term sedation exposure of pediatric intensive care patients

2013 ◽  
Vol 3 (11) ◽  
Author(s):  
Susanne Kotz
Keyword(s):  
Intensive Care ◽  
Pediatric Intensive Care ◽  
Withdrawal Symptoms ◽  
Intensive Care Patients

scholarly journals Effects of Clonidine on Withdrawal From Long-term Dexmedetomidine in the Pediatric Patient

2015 ◽  
Vol 20 (1) ◽  
pp. 45-53 ◽  
Author(s):  
Allison B. Lardieri ◽  
Nicholas M. Fusco ◽  
Shari Simone ◽  
L. Kyle Walker ◽  
Jill A. Morgan ◽  
...  
Keyword(s):  
Heart Rate ◽  
Assessment Tool ◽  
Pediatric Intensive Care ◽  
Primary Objective ◽  
Withdrawal Symptoms ◽  
Intensive Care Patients ◽  
Blood Pressures ◽  
Secondary Objective ◽  
The Mean

OBJECTIVE: To compare withdrawal symptoms among pediatric intensive care patients receiving clonidine to those not receiving clonidine while being weaned from long-term dexmedetomidine. METHODS: This retrospective analysis evaluated Withdrawal Assessment Tool-1 (WAT-1) scores and hemodynamic parameters in pediatric patients on dexmedetomidine for 5 days or longer between January 1, 2009, and December 31, 2012. The primary objective was to compare withdrawal symptoms based on the number of elevated WAT-1 scores among patients on clonidine to those not on clonidine, while being weaned from long-term dexmedetomidine. The secondary objective was to describe withdrawal symptoms associated with long-term dexmedetomidine use. RESULTS: Nineteen patients (median age, 1.5 years; interquartile range [IQR], 0.67–3.3) received 20 treatment courses of dexmedetomidine for at least 5 days. Clonidine was received by patients during 12 of the treatment courses. The patients in the clonidine group had an average of 0.8 (range, 0–6) elevated WAT-1 scores 24 hours post wean compared to an average of 3.2 (0–8) elevated WAT-1 scores in the no clonidine group (p = 0.49). There were no significant difierences between prewean and postwean systolic or diastolic blood pressures among the 2 groups. The average heart rate during the postwean period was 112 beats per minute (bpm) (range, 88.5–151.5) in the clonidine group compared to 138.4 bpm (range, 117.8–168.3) in the no clonidine group (p = 0.003). In the clonidine group, the mean change in heart rate postwean compared to prewean was an increase of 3.6 bpm (range, −39.6 to 47.5), compared to a mean increase of 29.9 bpm (range, 5.5–74.7) in the no clonidine group (p = 0.042). CONCLUSIONS: There was no difierence in WAT-1 scores between groups, with the clonidine group displaying a trend towards fewer elevated WAT-1 scores during the 24 hours post dexmedetomidine wean. Patients who received clonidine had significantly lower heart rates than the no clonidine group.

The Impact of Implementing a “Pain, Agitation, and Delirium Bundle” in a Pediatric Intensive Care Unit: Improved Delirium Diagnosis

2021 ◽  
Author(s):  
Lise D. Cloedt ◽  
Kenza Benbouzid ◽  
Annie Lavoie ◽  
Marie-Élaine Metras ◽  
Marie-Christine Lavoie ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Pediatric Intensive Care ◽  
Post Intervention ◽  
Number Of Patients ◽  
Implementation Period ◽  
Short And Long Term ◽  
The Impact

AbstractDelirium is associated with significant negative outcomes, yet it remains underdiagnosed in children. We describe the impact of implementing a pain, agitation, and delirium (PAD) bundle on the rate of delirium detection in a pediatric intensive care unit (PICU). This represents a single-center, pre-/post-intervention retrospective and prospective cohort study. The study was conducted at a PICU in a quaternary university-affiliated pediatric hospital. All patients consecutively admitted to the PICU in October and November 2017 and 2018. Purpose of the study was describe the impact of the implementation of a PAD bundle. The rate of delirium detection and the utilization of sedative and analgesics in the pre- and post-implementation phases were measured. A total of 176 and 138 patients were admitted during the pre- and post-implementation phases, respectively. Of them, 7 (4%) and 44 (31.9%) were diagnosed with delirium (p < 0.001). Delirium was diagnosed in the first 48 hours of PICU admission and lasted for a median of 2 days (interquartile range [IQR]: 2–4). Delirium diagnosis was higher in patients receiving invasive ventilation (p < 0.001). Compliance with the PAD bundle scoring was 79% for the delirium scale. Score results were discussed during medical rounds for 68% of the patients in the post-implementation period. The number of patients who received opioids and benzodiazepines and the cumulative doses were not statistically different between the two cohorts. More patients received dexmedetomidine and the cumulative daily dose was higher in the post-implementation period (p < 0.001). The implementation of a PAD bundle in a PICU was associated with an increased recognition of delirium diagnosis. Further studies are needed to evaluate the impact of this increased diagnostic rate on short- and long-term outcomes.

scholarly journals Pharmacokinetics of Daptomycin in Pediatric Intensive Care Patients

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S291-S292
Author(s):  
Charalampos Antachopoulos ◽  
Paschalis Kadiltzoglou ◽  
Stavroula Ilia ◽  
George Briassoulis ◽  
Anastasia Geladari ◽  
...  
Keyword(s):  
Intensive Care ◽  
Pediatric Intensive Care ◽  
Intensive Care Patients

scholarly journals Population pharmacokinetics of dexmedetomidine during long-term sedation in intensive care patients

2012 ◽  
Vol 108 (3) ◽  
pp. 460-468 ◽  
Author(s):  
T. Iirola ◽  
H. Ihmsen ◽  
R. Laitio ◽  
E. Kentala ◽  
R. Aantaa ◽  
...  
Keyword(s):  
Intensive Care ◽  
Population Pharmacokinetics ◽  
Intensive Care Patients

The Role of Long-Term Electroencephalogram Monitoring in the Prognostic Evaluation of Children with Disturbance of Consciousness in Pediatric Intensive Care Unit

2021 ◽  
Vol 7 (5) ◽  
pp. 1214-1221
Author(s):  
Xiaobo Wu ◽  
Ruiqin Qiu ◽  
Baoqi Li ◽  
Heyuan Gao ◽  
Ying Su
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Medical Records ◽  
Compliance Rate ◽  
Pediatric Intensive Care ◽  
Prognostic Evaluation ◽  
Disturbance Of Consciousness

This study aimed to investigate the role of long-term video electroencephalogram (VEEG) monitoring in the diagnosis and prognostic evaluation of children with disturbance of consciousness in pediatric intensive care unit (PICU). Materials and Methods : A retrospective analysis was performed on the medical records of 107 children with severe brain injury (SBI) who admitted to the PICU of The First Hospital of Qinhuangdao from January 2014 to December 2015. The medical records of 100 children with mild disturbance of consciousness were analyzed. All children underwent routine electroencephalogram (REEG) and VEEG detections. The diagnosis was completed by physicians according to the relevant operation instructions. The brain waveform of children was monitored. Result : The diagnostic results of REEG and VEEG were compared with clinical diagnostic results, and the relationship between the two detections and the prognosis of SBI children was analyzed. The sensitivity of VEEG in the diagnosis of SBI children was significantly higher than that of REEG (P<0.050). The specificity of VEEG in the diagnosis of SBI children was higher than that of REEG, with a statistical significance (P<0.050). The diagnostic compliance rate of VEEG in the diagnosis of SBI children was significantly higher than that of REEG (P<0.050). The sensitivity of VEEG in evaluating the prognosis of SBI children was significantly higher than that of REEG (P<0.050). The specificity of VEEG in evaluating the prognosis of SBI children was significantly higher than that of REEG. The coincidence rate of VEEG in evaluating the prognosis of SBI children was significantly higher than that of REEG (P<0.050). Conclusion: The results indicated that VEEG detection is effective in the diagnosis and prognostic evaluation of SBI children with disturbance of consciousness, which is worthy of promotion in clinical practice.

An Evaluation of Fatality Rates in Pediatric Intensive Care Patients

1989 ◽  
Vol 22 (4) ◽  
pp. 525
Author(s):  
Seong Deok Kim ◽  
Yong Seok Oh ◽  
Hyun Ok Yoon
Keyword(s):  
Intensive Care ◽  
Pediatric Intensive Care ◽  
Intensive Care Patients
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