Analgesia-Sedation in PICU and Neurological Outcome: A Secondary Analysis of Long-Term Neuropsychological Follow-Up in Meningococcal Septic Shock Survivors*
Analgesia-Sedation in PICU and Neurological Outcome: A Secondary Analysis of Long-Term Neuropsychological Follow-Up in Meningococcal Septic Shock Survivors*
复制标题
PICU 中的镇痛镇静和神经系统结果：脑膜炎球菌感染性休克幸存者长期神经心理学随访的二次分析*
DOI：
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发表时间：
2014
影响因子：
4.1
通讯作者：
C. Buysse
中科院分区：
文献类型：
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作者：
L. van Zellem;E. Utens;S. D. de Wildt;N. Vet;D. Tibboel;C. Buysse
Objectives: To investigate whether analgesic and sedative drug use during PICU treatment is associated with long-term neurodevelopmental outcome in children who survived meningococcal septic shock. Design: This study concerned a secondary analysis of data from medical and psychological follow-up of a cross-sectional cohort of all consecutive surviving patients with septic shock and purpura requiring intensive care treatment between 1988 and 2001 at the Erasmus MC-Sophia Children’s Hospital. At least 4 years after PICU admission, these children showed impairments on several domains of neuropsychological functioning. In the present study, type, number, and dose of sedatives and analgesics were retrospectively evaluated. Setting: Tertiary care university hospital. Patients: Seventy-seven meningococcal septic shock survivors (median age, 2.1 yr). Interventions: None. Measurements and Main Results: Forty-five patients (58%) received one or more analgesic and/or sedative drugs during PICU admission, most commonly benzodiazepines (n = 39; 51%), followed by opioids (n = 23; 30%). In total, 12 different kinds of analgesic or sedative drugs were given. The use and dose of opioids were significantly associated with poor test outcome on full-scale intelligence quotient (p = 0.02; Z = –2.28), verbal intelligence quotient (p = 0.02; Z = –2.32), verbal intelligence quotient subtests (verbal comprehension [p = 0.01; Z = –2.56] and vocabulary [p = 0.01; Z = –2.45]), and visual attention/executive functioning (Trial Making Test part B) (p = 0.03; Z = –2.17). In multivariate analysis adjusting for patient and disease characteristics, the use of opioids remained significant on most neuropsychological tests. Conclusions: The use of opioids during PICU admission was significantly associated with long-term adverse neuropsychological outcome independent of severity of illness scores in meningococcal septic shock survivors.
影响因子：
37.8
作者：
WERNOVSKY, G;WYPIJ, D;WESSEL, DL
通讯作者：
WESSEL, DL