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Withdrawal from lorazepam in critically ill children

Karen D Dominguez1, Mark R Crowley, Denise M Coleman

  • 1College of Pharmacy, University of New Mexico Health Sciences Center, Albuquerque, 87131, USA. kdominguez@salud.unm.edu

The Annals of Pharmacotherapy
|May 25, 2006
PubMed

Insights

Lorazepam withdrawal occurred in 24% of critically ill children after long-term use for mechanical ventilation. Predictors for this benzodiazepine withdrawal syndrome in pediatric patients remain unknown.

Area of Science:

  • Pediatric Critical Care Medicine
  • Pharmacology
  • Neuroscience

Background:

  • Sedatives are crucial for mechanical ventilation in critically ill children.
  • Benzodiazepine use, including lorazepam, can lead to tolerance and withdrawal.
  • Limited data exists on lorazepam withdrawal in pediatric intensive care settings.

Purpose of the Study:

  • To determine the incidence of lorazepam withdrawal in critically ill children.
  • To identify potential predictors for developing lorazepam withdrawal.

Main Methods:

  • Prospective, open-label study of pediatric patients receiving continuous lorazepam infusion for ≥72 hours.
  • Lorazepam was tapered over 6 days, with discontinuation following.
  • Withdrawal assessed by attending physicians; risk factors analyzed using demographic, dosing, and serum concentration data.

Main Results:

  • Twenty-nine patients completed the study; 7 (24%) experienced lorazepam withdrawal.
  • No significant differences found in demographics, sedative use, or lorazepam levels between groups.
  • No specific predictors for lorazepam withdrawal were identified.

Conclusions:

  • A significant percentage of critically ill children (24%) experienced lorazepam withdrawal.
  • Current data does not identify risk factors for this withdrawal syndrome.
  • Further research is needed to understand and predict lorazepam withdrawal in pediatric patients.
Abstract

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