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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
Summary
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.