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Propofol PICU

V Nakou, K Williamson, T Arichi, D E Lumsden, Steve Tomlin, M Kaminska, J-P Lin
OBJECTIVE: Acute dystonia in children is distressing, painful and can progress to life-threatening status dystonicus. Typical management involves benzodiazepines which can result in respiratory depression requiring PICU admission. Clonidine is less respiratory-depressant, and by facilitating sleep, switches dystonia off. It can also be administered via enteral, continuous intravenous infusion, and transdermal slow release routes. We describe the dose range and safety profile of clonidine management in a case-series of children with severe acute exacerbation of dystonia in a tertiary hospital setting...
November 2017: European Journal of Paediatric Neurology: EJPN
Nadia Roumeliotis, Christian Dong, Géraldine Pettersen, Louis Crevier, Guillaume Emeriaud
OBJECTIVES: The objectives of the study are to describe the use of hyperosmolar therapy in pediatric traumatic brain injury (TBI) and examine its effect on intracranial pressure (ICP) and cerebral perfusion pressure (CPP). DESIGN: A retrospective review of patients with severe TBI admitted to the pediatric intensive care unit (PICU) was conducted. Inclusion criteria were ICP monitoring and administration of a hyperosmolar agent (20 % mannitol or 3 % hypertonic saline) within 48 h of PICU admission; for which dose and timing were recorded...
December 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Itai Pessach, Gideon Paret
No abstract text is available yet for this article.
March 2016: Pediatric Critical Care Medicine
I Tully, E S Draper, C R Lamming, D Mattison, C Thomas, T Martland, R Appleton
AIMS: To obtain national epidemiological data on the aetiology, management and outcome of refractory convulsive status epilepticus (RCSE) in children. METHODS: Data on children admitted with RCSE between 01.01.2008 and 31.12.2009, to eight paediatric intensive care units (PICUs) were retrospectively collected using a standard proforma designed with and co-ordinated by PICANet. RESULTS: Data were collected on 245 (male, 179) patients aged between <1 month and 16...
July 2015: Seizure: the Journal of the British Epilepsy Association
Barry P Markovitz
No abstract text is available yet for this article.
July 2014: Pediatric Critical Care Medicine
Hiromi Koriyama, Jonathan P Duff, Gonzalo Garcia Guerra, Alice W Chan
OBJECTIVE: The primary objective is to describe the practice patterns of nonprocedural propofol use in a single-center referral PICU. The secondary objective is to describe the rate of concordance of propofol use with the PICU local practice of a maximum mean rate of 4 mg/kg/hr and a maximum duration of 24 hours and to assess for signs and symptoms of propofol infusion syndrome. DESIGN: Retrospective descriptive cohort study. SETTING: PICU of a tertiary care teaching hospital and referral hospital for the Western Canada...
February 2014: Pediatric Critical Care Medicine
Marie-Louise Svensson, Lars Lindberg
BACKGROUND: The aim of this study was to prospectively evaluate and report the experience of the use of continuous intravenous propofol sedation in a paediatric intensive care unit (PICU). METHODS: All children younger than 16 years who were admitted to the PICU at a University Hospital for slightly more than a year and received propofol infusion were included prospectively and data were recorded before and within 6 h after completion of the propofol infusion. RESULTS: A total of 174 out of 955 children (18·2%) received propofol infusion for sedation...
July 2012: Nursing in Critical Care
F J Alados-Arboledas, P Millán-Bueno, J F Expósito-Montes, J de la Cruz-Moreno, A Pérez-Parras, A Arévalo-Garrido
INTRODUCTION: Invasive procedures (IP) are an important reason for admision to PICU. Paediatric patients need a special anaesthetic approach and deep sedation is frequently required. The objective was to evaluate the safety and efficacy of continuous infusion propofol to achieve sedation for diagnostic upper gastrointestinal endoscopy (UGE) in spontaneous breathing. PATIENTS AND METHODS: Prospective observational study. SCOPE: Secondary hospital Paediatric Intensive Care Unit...
August 2011: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
S Mencía, M Botrán, J López-Herce, J del Castillo et al.
OBJECTIVE: The aim of the study was to define the strategies for the use and monitoring of sedative, analgesic, and muscle relaxant medication in Spanish paediatric intensive care units (PICU). MATERIAL AND METHODS: A questionnaire with 102 questions was sent by e-mail to all Spanish PICUs. RESULTS: Replies were received from 36 of the 45 PICUs (80%). A written protocol for sedation and analgesia was used in 64%; this medication was adjusted according to the diagnosis and clinical status of the patient in 30% of the units...
June 2011: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
Michael Vespasiano, Marsha Finkelstein, Stephen Kurachek
OBJECTIVE: The objective of this study was to determine the safety profile of propofol as a deep-sedation agent in a primarily outpatient program consisting of pediatric critical care physicians and specifically trained nurses with oversight provided by anesthesiology. One hypothesis was investigated: adverse events and/or airway interventions are more likely to occur in children with an abnormal airway score. METHODS: A 36-month dual-site prospective, observational, clinical study was conducted in a single center with interchangeable providers operating within the guidelines of a single sedation program...
December 2007: Pediatrics
J M López, M Valerón, O Pérez, E Consuegra, L Urquía, A Morón, R González
OBJECTIVE: Apply a sedoanalgesic (SA) protocol for invasive procedures (PI) in pediatric patients and evaluate its effectiveness and safety. DESIGN: Prospective observational study. SCOPE: Pediatric Intensive Care Unit (PICU) of third level hospital. PATIENTS: A total of 110 children subjected to invasive procedures under sedoanalgesia with propofol and fentanyl. INTERVENTION: Sedoanalgesic protocol for invasive procedure was applied with: fentanyl (1-2 mcg/kg with maximum dose of 100 mcg for first dose and 50 mcg for the next) and propofol (1-2 mg/kg with maximum of 100 mg for first dose and 50 mg for the next)...
November 2007: Medicina Intensiva
Joseph D Tobias
Various clinical situations may arise in the PICU that necessitate the use of sedation, analgesia, or both. Although there is a large clinical experience with midazolam in the PICU population and it remains the most commonly used benzodiazepine in this setting, lorazepam may provide an effective alternative, with a longer half-life and more predictable pharmacokinetics without the concern of active metabolites. However, there are limited reports regarding its use in the PICU population, and concerns exist regarding the potential for toxicity related to its diluent, propylene glycol...
August 2005: Pediatric Annals
Stephen D Playfor, K Venkatesh
BACKGROUND: Our aim was to investigate the current patterns of propofol use in pediatric intensive care units (PICUs) in the UK and North America. METHODS: An electronic questionnaire was sent to all PICUs in the UK and those units offering PICU training fellowships in the USA and Canada. RESULTS: We received responses from 15 UK units (75%) and 33 units in North America (52%). Of units who responded, 47% of UK units used propofol for ongoing sedation, compared with 61% of North American units...
June 2004: Paediatric Anaesthesia
Derek S Wheeler, Keith K Vaux, Michael L Ponaman, Bradley W Poss
OBJECTIVES: To describe our experience using propofol sedation to facilitate elective diagnostic and therapeutic procedures, and to document the safety profile of propofol in this setting. DESIGN: Retrospective consecutive case series and review of the literature. SETTING: Pediatric intensive care unit of a United States Navy tertiary care medical center. PATIENTS: Children receiving propofol for procedural sedation over an 18-month period...
December 2003: Pediatric Emergency Care
Scott M Klein, Gabriel J Hauser, Barry D Anderson, Aziza T Shad, Joseph E Gootenberg, Heidi J Dalton, James H Hertzog
OBJECTIVE: To compare the effects of administering propofol as a continuous infusion vs. bolus dosing in children undergoing ambulatory oncologic procedures in the pediatric intensive care unit (PICU). DESIGN: Prospective, randomized study. SETTING: Tertiary PICU in a university hospital. PATIENTS: Ambulatory oncology patients scheduled for diagnostic or therapeutic procedures with propofol anesthesia in the PICU were eligible for enrollment...
January 2003: Pediatric Critical Care Medicine
M Festa, J Bowra, D Schell
Despite the risk of propofol infusion syndrome, a rare but often fatal complication of propofol infusion in ventilated children and possibly adults, propofol infusion remains in use in paediatric intensive care units (PICU). This questionnaire study surveys the current pattern of use of this sedative infusion in Australian and New Zealand PICUs. Thirty-three of the 45 paediatric intensive care physicians surveyed (73%), from 12 of the 13 intensive care units, returned completed questionnaires. The majority of practitioners (82%) use propofol infusion in children in PICU, the main indication being for short-term sedation in children requiring procedures...
December 2002: Anaesthesia and Intensive Care
J H Hertzog, H J Dalton, B D Anderson, A T Shad, J E Gootenberg, G J Hauser
OBJECTIVES: To evaluate our experience with propofol anesthesia delivered by pediatric intensivists in the pediatric intensive care unit (PICU) to facilitate elective oncology procedures in children performed by pediatric oncologists. METHODS: Elective oncology procedures performed with propofol anesthesia in our multidisciplinary, university-affiliated PICU were prospectively evaluated over a 7-month period. Ambulatory and hospitalized children were prescheduled for their procedure, underwent a medical evaluation, and met fasting requirements before the start of anesthesia...
October 2000: Pediatrics
J D Tobias
The indications for sedation in the paediatric intensive care unit (PICU) patient are varied ranging from short term use for various procedures to prolonged administration to provide comfort during mechanical ventilation. When faced with the decision to institute sedation, the healthcare provider must make three decisions: the agent to be used, the route of delivery, and the mode of administration (intermittent versus continuous). There are several agents that have been used to provide sedation in the PICU patient including the inhalational anaesthetic agents, benzodiazepines, opioids, ketamine, propofol, chloral hydrate, phenothiazines, and the barbiturates...
April 1999: Paediatric Drugs
J D Tobias
OBJECTIVE: To describe the consequences of the prolonged administration of sedative and analgesic agents to the pediatric intensive care unit (PICU) patient. The problems to be investigated include tolerance, physical dependency, and withdrawal. DATA SOURCES: A MEDLINE search was performed of literature published in the English language. Cross-reference searches were performed using the following terms: sedation, analgesia with PICU, children, physical dependency, withdrawal; tolerance with sedative, analgesics, benzodiazepines, opioids, inhalational anesthetic agents, nitrous oxide, ketamine, barbiturates, propofol, pentobarbital, phenobarbital...
June 2000: Critical Care Medicine
R Gillerman, J Duncan, J Bolton
A 3-year-old child was brought to the operating room for removal of a brainstem juvenile pilocytic astrocytoma. Following inhalation induction and intubation, he was maintained on 0.5% isoflurane. Somatosensory evoked potentials (SSEPs) were recorded but unobtainable initially and up to 90 min after all inhalation agents were discontinued. The operation was cancelled and the patient was transported to the paediatric intensive care unit (PICU). Subsequent PICU testing revealed a depression of amplitude with propofol and absence of potentials with 0...
2000: Paediatric Anaesthesia
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