Use of fentanyl and midazolam in mechanically ventilated children--Does the method of infusion matter?

Journal of Critical Care
Paulo Sérgio Lucas da SilvaMarcelo Cunio Machado Fonseca

Abstract

Benzodiazepines and opioids are commonly used in pediatric intensive care unit. However, there is no previous study assessing the use of administering these drugs combined (single solution) or separately. We sought to evaluate the impact of these 2 different methods of providing sedation/analgesia in pediatric intensive care unit. One hundred twelve patients mechanically ventilated for more than 48 hours were randomized to receive a protocolized sedation regime comprising midazolam and fentanyl either separately (group 1, 57 patients) or combined as a single solution (group 2, 55 patients). Primary end point variable was the cumulated dose of midazolam and fentanyl. The median cumulated doses of both fentanyl (0.19 vs 0.37 mg/kg, P < .05) and midazolam (28.8 vs 45.6 mg/kg, P < .05) required in group 2 were higher when compared with those of group 1. Moreover, group 2 patients had a significantly longer time of vasopressor drugs requirement and a higher number of patients developing tolerance. Patients who received a single solution of midazolam and fentanyl had a higher cumulated dose of compared with those patients who did not. The potential risk for long-term neurologic effects on developing brains associated with this findin...Continue Reading

References

Nov 1, 1988·Critical Care Medicine·M M PollackP R Getson
Aug 26, 1998·Journal of Pain and Symptom Management·K M WilsonP J Ravenscroft
Jan 8, 2005·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Erwin IstaMatthijs de Hoog
Feb 18, 2006·Critical Care Medicine·Martin W DünserLundeg Ganbold
May 16, 2006·Intensive Care Medicine·Stephen PlayforUNKNOWN Analgesia and Neuromuscular Blockade Working Group
May 24, 2008·Anesthesia and Analgesia·Andreas W Loepke, Sulpicio G Soriano
Apr 16, 2009·Intensive Care Medicine·Erwin IstaHugo J Duivenvoorden
Sep 23, 2009·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Andreas W Loepke
Apr 21, 2010·Pediatrics·Kanwaljeet J S AnandUNKNOWN Eunice Kennedy Shriver National Institute of Child Health and Human Development Collaborative Pediatric Critical Care Resear
Feb 2, 2011·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Kunal GuptaSunit Singhi
Apr 22, 2011·Paediatric Anaesthesia·Gonzalo Garcia GuerraUNKNOWN Western Canadian Complex Pediatric Therapies Follow-up Group
Oct 25, 2012·Biochemia Medica·Mary L McHugh
May 7, 2013·Heart & Lung : the Journal of Critical Care·Mary Jo C GrantUNKNOWN RESTORE Investigative Team
Jun 20, 2013·Intensive Care Medicine·Nienke J VetMatthijs de Hoog
Aug 22, 2013·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Erwin IstaMonique van Dijk
Dec 25, 2013·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Lennart van ZellemCorinne Buysse

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.