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

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

Author Lucas da Silva, Paulo Sergio Google Scholar
Reis, Maria Eunice Google Scholar
de Aguiar, Vania Euzebio Google Scholar
Machado Fonseca, Marcelo Cunio Autor UNIFESP Google Scholar
Abstract Background and objective: 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. Methods: One hundred twelve patients mechanically ventilated for more than 48 hours were randomized to receive a protocolized sedation regimecomprising midazolamand 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. Results: 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. Conclusion: 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 finding should be considered. (C) 2015 Elsevier Inc. All rights reserved.
Keywords Benzodiazepine
Fentanyl
Midazolam
Opiate
Pediatric intensive care
Sedation
xmlui.dri2xhtml.METS-1.0.item-coverage Philadelphia
Language English
Date 2016
Published in Journal Of Critical Care. Philadelphia, v. 32, p. 108-113, 2016.
ISSN 0883-9441 (Sherpa/Romeo, impact factor)
Publisher W B Saunders Co-Elsevier Inc
Extent 108-113
Origin http://dx.doi.org/10.1016/j.jcrc.2015.12.003
Access rights Closed access
Type Article
Web of Science ID WOS:000370866900021
URI https://repositorio.unifesp.br/handle/11600/57762

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