Dexmedetomidine and iatrogenic withdrawal syndrome in critically ill children
BM Geven, JM Maaskant, CS Ward, JBM van Woensel - Critical care nurse, 2021 - AACN
BM Geven, JM Maaskant, CS Ward, JBM van Woensel
Critical care nurse, 2021•AACNBackground Iatrogenic withdrawal syndrome is a well-known adverse effect of sedatives and
analgesics commonly used in patients receiving mechanical ventilation in the pediatric
intensive care unit, with an incidence of up to 64.6%. When standard sedative and analgesic
treatment is inadequate, dexmedetomidine may be added. The effect of supplemental
dexmedetomidine on iatrogenic withdrawal syndrome is unclear. Objective To explore the
potentially preventive effect of dexmedetomidine, used as a supplement to standard …
analgesics commonly used in patients receiving mechanical ventilation in the pediatric
intensive care unit, with an incidence of up to 64.6%. When standard sedative and analgesic
treatment is inadequate, dexmedetomidine may be added. The effect of supplemental
dexmedetomidine on iatrogenic withdrawal syndrome is unclear. Objective To explore the
potentially preventive effect of dexmedetomidine, used as a supplement to standard …
Background
Iatrogenic withdrawal syndrome is a well-known adverse effect of sedatives and analgesics commonly used in patients receiving mechanical ventilation in the pediatric intensive care unit, with an incidence of up to 64.6%. When standard sedative and analgesic treatment is inadequate, dexmedetomidine may be added. The effect of supplemental dexmedetomidine on iatrogenic withdrawal syndrome is unclear.
Objective
To explore the potentially preventive effect of dexmedetomidine, used as a supplement to standard morphine and midazolam regimens, on the development of iatrogenic withdrawal syndrome in patients receiving mechanical ventilation in the pediatric intensive care unit.
Methods
This retrospective observational study used data from patients on a 10-bed general pediatric intensive care unit. Iatrogenic withdrawal syndrome was measured using the Sophia Observation withdrawal Symptoms-scale.
Results
In a sample of 102 patients, the cumulative dose of dexmedetomidine had no preventive effect on the development of iatrogenic withdrawal syndrome (P = .19). After correction for the imbalance in the baseline characteristics between patients who did and did not receive dexmedetomidine, the cumulative dose of midazolam was found to be a significant risk factor for iatrogenic withdrawal syndrome (P < .03).
Conclusion
In this study, supplemental dexmedetomidine had no preventive effect on iatrogenic withdrawal syndrome in patients receiving sedative treatment in the pediatric intensive care unit. The cumulative dose of midazolam was a significant risk factor for iatrogenic withdrawal syndrome.
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