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Intensive pediatric care drugs intravenous administration

Gerdien A Zeilmaker-Roest, Joost van Rosmalen, Monique van Dijk, Erik Koomen, Nicolaas J G Jansen, Martin C J Kneyber, Sofie Maebe, Greet van den Berghe, Dirk Vlasselaers, Ad J J C Bogers, Dick Tibboel, Enno D Wildschut
BACKGROUND: Morphine is worldwide the analgesic of first choice after cardiac surgery in children. Morphine has unwanted hemodynamic and respiratory side effects. Therefore, post-cardiac surgery patients may potentially benefit from a non-opioid drug for pain relief. A previous study has shown that intravenous (IV) paracetamol is effective and opioid-sparing in children after major non-cardiac surgery. The aim of the study is to test the hypothesis that intermittent IV paracetamol administration in children after cardiac surgery will result in a reduction of at least 30% of the cumulative morphine requirement...
June 13, 2018: Trials
Ahmed A El-Nawawy, Omneya M Omar, Mona Khalil
The cornerstone of emergency management of sepsis is early, goal-directed therapy. The purpose of this study was to evaluate the effect of intraosseous (IO) vs. intravenous (IV) access for resuscitation of patients with septic shock admitted to pediatric intensive care unit. This prospective interventional randomized clinical trial study was conducted on 60 patients with septic shock who need rapid administration of fluids and drugs; 30 cases were randomly chosen for IO vascular access, while the other 30 were selected for IV access...
April 1, 2018: Journal of Tropical Pediatrics
Robert B Flint, Carole N M Brouwer, Anne S C Kränzlin, Loraine Lie-A-Huen, Albert P Bos, Ron A A Mathôt
BACKGROUND: S-ketamine is the S(+)-enantiomer of the racemic mixture ketamine, an anesthetic drug providing both sedation and analgesia. In clinical practice, significant interpatient variability in drug effect of S-ketamine is observed during long-term sedation. AIMS: The aim of this study was to evaluate the pharmacokinetic variability of S-ketamine in children aged 0-18 years during long-term sedation. Twenty-five children (median age: 0.42 years, range: 0...
November 2017: Paediatric Anaesthesia
D El Mazloum, A Boner, A Pietrobelli
OBJECTIVE AND IMPORTANCE: Medication administration errors occur frequently in clinical practice. CLINICAL PRESENTATION: An 18-month-old child presented with vomiting and diarrhea. Due to a rise in temperature, paracetamol syrup was prescribed, but a nurse inadvertently administered the drug IV through the peripheral venous access. INTERVENTION: The child was referred to the pediatric intensive care unit where his clinical condition improved and the risk of peripheral venous and pulmonary embolism was excluded...
December 2016: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
Jainn-Jim Lin, Cheng-Che Chou, Shih-Yun Lan, Hsiang-Ju Hsiao, Yu Wang, Oi-Wa Chan, Shao-Hsuan Hsia, Huei-Shyong Wang, Kuang-Lin Lin
BACKGROUND: Evidence for the beneficial effect of therapeutic burst-suppression coma in pediatric patients with febrile refractory status epilepticus is limited, and the clinical outcomes of this treatment strategy are largely unknown. Therefore, the aim of this study was to explore the outcomes of therapeutic burst-suppression coma in a series of children with febrile refractory status epilepticus. METHODS: We retrospectively reviewed consecutive pediatric patients with febrile refractory status epilepticus admitted to our pediatric intensive care unit between January 2000 and December 2013...
September 2017: Brain & Development
Maud A S Weerink, Michel M R F Struys, Laura N Hannivoort, Clemens R M Barends, Anthony R Absalom, Pieter Colin
Dexmedetomidine is an α2 -adrenoceptor agonist with sedative, anxiolytic, sympatholytic, and analgesic-sparing effects, and minimal depression of respiratory function. It is potent and highly selective for α2 -receptors with an α2 :α1 ratio of 1620:1. Hemodynamic effects, which include transient hypertension, bradycardia, and hypotension, result from the drug's peripheral vasoconstrictive and sympatholytic properties. Dexmedetomidine exerts its hypnotic action through activation of central pre- and postsynaptic α2 -receptors in the locus coeruleus, thereby inducting a state of unconsciousness similar to natural sleep, with the unique aspect that patients remain easily rousable and cooperative...
August 2017: Clinical Pharmacokinetics
Jessica E Ericson, Martyn Gostelow, Julie Autmizguine, Christoph P Hornik, Reese H Clark, Daniel K Benjamin, P Brian Smith
BACKGROUND: Acyclovir is used to treat herpes simplex virus disease in infants. Treatment with high-dose acyclovir, 60 mg/kg/d, is recommended; however, the safety of this dosage has not been assessed in the past 15 years, and this dosage is not currently approved for infants by the US Food and Drug Administration. METHODS: We included infants with neonatal herpes simplex virus disease treated with ≥14 days of intravenous acyclovir starting in the first 120 days of life admitted to 1 of 42 neonatal intensive care units managed by the Pediatrix Medical Group between 2002 and 2012...
April 2017: Pediatric Infectious Disease Journal
Brady J Helmink, Carolyn E Ragsdale, Evan J Peterson, Kathryn G Merkel
OBJECTIVES: Evidence suggests palivizumab may be beneficial for respiratory syncytial virus (RSV) infection in pediatric patients, although it is only approved by the US Food and Drug Administration for RSV prophylaxis. The objective of this study is to compare outcomes among pediatric patients with RSV infection who received intravenous palivizumab and standard of care versus standard of care alone. METHODS: This is a retrospective, single-center cohort study conducted between November 2003 and October 2013...
March 2016: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
S Manrique-Rodríguez, A C Sánchez-Galindo, C M Fernández-Llamazares, M M Calvo-Calvo, Á Carrillo-Álvarez, M Sanjurjo-Sáez
OBJECTIVES: To estimate the impact of smart pump implementation in a pediatric intensive care unit in terms of number and type of administration errors intercepted. DESIGN: Observational, prospective study carried out from January 2010 to March 2015 with syringe and great volumen infusion pumps available in the hospital. SETTING: A tertiary level hospital pediatric intensive care unit. PARTICIPANTS: Infusions delivered with infusion pumps in all pediatric intensive care unit patients...
October 2016: Medicina Intensiva
Katharina Karsch, Xi Chen, Oliver Miera, Björn Peters, Patrick Obermeier, Roland C Francis, Válerie Amann, Susanne Duwe, Pieter Fraaij, Alla Heider, Marcel de Zwart, Felix Berger, Albert Osterhaus, Brunhilde Schweiger, Barbara Rath
BACKGROUND AND OBJECTIVES: Patients with severe influenza virus infection, multi-organ failure and organ replacement therapy may absorb and metabolize neuraminidase inhibitors differently. Systematic pharmacokinetic/pharmacodynamic clinical trials are currently lacking in this high-risk group. Inadequate dosing increases the risk of treatment failure and drug resistance, especially in severely ill patients with elevated virus loads. This study aims to explore the impact of organ replacement therapy on oseltamivir drug concentrations...
February 2017: European Journal of Drug Metabolism and Pharmacokinetics
J Pignard, S Cosserant, O Traore, B Souweine, V Sautou
OBJECTIVES: Infusion in care units, and all the more in intensive care units, is a complex process which can be the source of many risks for the patient. Under cover of an institutional approach for the improvement of the quality and safety of patient healthcare, a risk mapping infusion practices was performed. METHODS: The analysis was focused on intravenous infusion situations in adults, the a priori risk assessment methodology was applied and a multidisciplinary work group established...
March 2016: Annales Pharmaceutiques Françaises
Mohammad-Hasan Abdollahi, Khalil Foruzan-Nia, Mostafa Behjati, Babak Bagheri, Mehdi Khanbabayi-Gol, Shahla Dareshiri, Alireza Pishgahi, Rafie Zarezadeh, Nazgol Lotfi-Naghsh, Ainaz Lotfi-Naghsh, Mohammad Naghavi-Behzad
BACKGROUND: Post-operative fever is a common complication of cardiac operations, which is known to be correlated with a greater degree of cognitive dysfunction 6 weeks after cardiac surgery. The aim of the present study was to examine efficacy and safety of single dose intravenous Paracetamol in treatment of post-operative fever in children undergoing cardiac surgery. MATERIALS AND METHODS: In this randomised, double-blind, placebo-controlled clinical trial, 80 children, aged 1-12 years, presenting for open heart surgery were entered in the trial and randomly allocated into two groups: Placebo and Paracetamol...
September 2014: Nigerian Medical Journal: Journal of the Nigeria Medical Association
Yu-Cai Zhang, Xing-Wang Li, Xiao-Dong Zhu, Su-Yun Qian, Yun-Xiao Shang, Bi-Ru Li, Xiao-Lin Liu
BACKGROUND: Hand-foot-mouth disease has become a major public health issue in children in China. In the present prospective study we investigated the clinical characteristics and emergency management of children with severe encephalitis associated with NPE caused by enterovirus 71. METHODS: The study was conducted in 2 pediatric intensive care units (PICUs) over a 2-month period. Clinical records were reviewed of critically ill children with severe encephalitis associated with NPE caused by EV71 who were admitted to PICUs during the period of May to June 2008 in Fuyang...
2010: World Journal of Emergency Medicine
Daniel J Lebovitz, Paul G Smith, MaryAnn O'Riordan, Michael D Reed
BACKGROUND: Asthmatic children requiring treatment in the pediatric intensive care unit (PICU) receive aggressive drug therapy that may include IV administration of β 2-receptor agonists to prevent progression to life-threatening respiratory failure. The only pharmacologic agent in this class currently available for parenteral use in the United States is terbutaline. Study of IV dosing of terbutaline in the pediatric population has been limited. OBJECTIVE: The aim of this study was to determine the pharmacokinetic (PK) properties and tolerability of single-dose terbutaline in pediatric patients across a broad age range who were admitted to the PICU and were receiving maximal conventional asthma drug therapy...
January 2004: Current Therapeutic Research, Clinical and Experimental
Silvia Manrique-Rodríguez, Amelia Sánchez-Galindo, Cecilia M Fernández-Llamazares, Jesús López-Herce, Milagrosa Rodríguez-Gómez, Lara Echarri-Martínez, Angel Carrillo-Álvarez, María Sanjurjo-Sáez
Drug administration is one of the main sources of errors in pediatric intensive care units (PICUs). An available guide for intravenous drug administration might be useful. The aim of this article is to present the methodology and results for the development of a guide for intravenous drug administration in a PICU. A total of 116 drugs were included. Standard concentrations, diluents, technique for reconstitution and dilution, stability, rate of administration, and relevant observations were defined for each drug according to a review of the most commonly used literature resources...
January 2014: Journal of Infusion Nursing: the Official Publication of the Infusion Nurses Society
Christopher W Mastropietro, Renee Barrett, Maria Caridad Davalos, Marwan Zidan, Kevin M Valentine, Ralph E Delius, Henry L Walters
BACKGROUND: Children undergoing cardiac surgery may receive corticosteroids preoperatively to temper cardiopulmonary bypass-related inflammation, postoperatively for hemodynamic instability, and periextubation to reduce airway edema. Recent data have associated preoperative corticosteroids with infection. We aimed to determine if there is a relationship between cumulative corticosteroid exposure and infection. METHODS: A retrospective review of children who underwent cardiac surgery at our institution from January 2009 to July 2010 was performed...
June 2013: Annals of Thoracic Surgery
James M DeMasi, Jennifer A Cox, David Leonard, Andrew Y Koh, Victor M Aquino
BACKGROUND: Pneumocystis carinii pneumonia (PCP) is a potentially life-threatening but preventable infection that may occur after hematopoietic stem cell transplantation (HSCT). Intravenous pentamidine has been used in the prevention of PCP in the post-transplant period, although there are few trials published in the literature evaluating its safety and efficacy. METHODS: We retrospectively reviewed the medical records of children who underwent HSCT from January 1, 2005, to October 1, 2011, who received intravenous pentamidine as first-line PCP prophylaxis initiated at admission...
September 2013: Pediatric Infectious Disease Journal
Ibrahim Ince, Saskia N de Wildt, Chenguang Wang, Chengueng Wang, Mariska Y M Peeters, Jacobus Burggraaf, Evelyne Jacqz-Aigrain, John N van den Anker, Dick Tibboel, Meindert Danhof, Catherijne A J Knibbe
BACKGROUND AND OBJECTIVE: Major changes in cytochrome P450 (CYP) 3A activity may be expected in the first few months of life with, later, relatively limited changes. In this analysis we studied the maturation of in vivo CYP3A-mediated clearance of midazolam, as model drug, from preterm neonates of 26 weeks gestational age (GA) to adults. METHODS: Pharmacokinetic data after intravenous administration of midazolam were obtained from six previously reported studies...
July 2013: Clinical Pharmacokinetics
Deshui Yu, Yan Jiang, Jin Gao, Bin Liu, Ping Chen
Previous studies have shown that exposure of the immature brain to drugs that block NMDA glutamate receptors or drugs that potentiate GABA(A) receptors can trigger widespread neuroapoptosis. Almost all currently used general anesthetics have either NMDA receptor blocking or GABA(A) receptor enhancing properties. Propofol, a new intravenous anesthetic, is widely used in pediatric anesthesia and intensive care practice whose neurotoxicity on brain development remains unknown. We investigated the effects of neonatal propofol anesthesia on neuroapoptosis and long-term spatial learning/memory functions...
February 8, 2013: Neuroscience Letters
Joseph M Larochelle, Jill A Morgan, Kristine A Parbuoni
BACKGROUND: The 2008 Surviving Sepsis Campaign guidelines state that intravenous antibiotic therapy should be started within the first hour of recognition of septic shock. Currently, there are no published studies looking at antibiotic timing in pediatric sepsis patients. OBJECTIVES: The purpose of this study is to determine if sepsis patients admitted to a Pediatric Intensive Care Unit (PICU) are administered antibiotics in the appropriate time frame according to the Surviving Sepsis Guidelines...
October 2009: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
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