Occurrence of withdrawal in critically ill sedated children
Occurrence of withdrawal in critically ill sedated children
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DOI：
10.1097/00003246-199901000-00052
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发表时间：
1999-01-01
影响因子：
8.8
通讯作者：
Carl, P
中科院分区：
文献类型：
--
作者：
Fonsmark, L;Rasmussen, YH;Carl, P
目的：记录机械通气镇静剂给药后出现戒断症状的儿童数量，并讨论与咪达唑仑给药的可能联系。设计：从病例记录和图表中收集回顾性数据。设置：大学医院内科和外科重症监护室（ICU）。患者：6个月至14岁的儿童谁需要镇静机械通气（n = 40）。干预措施：无。测量和主要结果：镇静剂和镇痛剂的种类和数量，管理的持续时间，以及戒断症状的发生。戒断症状发生率为35%（14/40）。咪达唑仑总剂量>60 mg/kg与停药的发生密切相关。统计分析，以确定与吗啡的管理相关的戒断反应的发生是不可能的。结论：在几个孩子的戒断反应的体征和症状。戒断的发生与高剂量咪达唑仑在统计学上相关，但无法确定吗啡的影响。如果使用了大剂量的咪达唑仑和阿片类药物，可能有理由逐渐减少剂量而不是突然减少剂量，或者在停止镇静时使用长效苯二氮卓类药物或阿片类药物。
Objectives: To record the number of children with withdrawal symptoms after the administration of sedatives for mechanical ventilation, and to discuss the possible connection with the administration of midazolam.Design: Retrospective data collection from case records and charts.Setting: Medical and surgical intensive care unit (ICU) in a university hospital.Patients: Children 6 months to 14 yrs of age who required sedation for mechanical ventilation (n = 40).Interventions: None.Measurements and Main Results: Kind and amount of sedatives and analgesics, duration of administration, and occurrence of withdrawal symptoms. The frequency of withdrawal symptoms was 35% (14/40) of the sedated children. A total dose of midazolamof >60 mg/kg was strongly significantly associated with occurrence of withdrawal. Statistical analysis to determine the occurrence of withdrawal associated with the administration of morphine was not possible.Conclusions: Signs and symptoms of a withdrawal reaction were observed in several children. The occurrence of withdrawal was statistically related to high doses of midazolam, but it was not possible to determine the influence of morphine. if large doses of midazolam and opioids have been administered, there may be justification for reducing the dose gradually instead of abruptly, or using longer acting benzodiazepines or opiods on discontinuation of sedation.