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Withdrawal syndrome in the pediatric intensive care unit. Incidence and risk factors

F Fernández-Carrión1, M Gaboli, R González-Celador

  • 1Unidad de Cuidados Intensivos Pediátricos, Hospital Universitario de Salamanca, Salamanca, Spain. pacojum@gmail.com

Medicina Intensiva
|May 22, 2012
PubMed

Insights

Fifty percent of pediatric patients experienced withdrawal syndrome after prolonged fentanyl and midazolam infusions. Longer infusion duration and higher cumulative drug doses were identified as key risk factors for this withdrawal syndrome.

Area of Science:

  • Pediatric Intensive Care
  • Pharmacology
  • Clinical Medicine

Background:

  • Prolonged use of fentanyl and midazolam is common in pediatric intensive care for sedation and analgesia.
  • Understanding withdrawal syndrome incidence and risk factors is crucial for patient safety.

Purpose of the Study:

  • To determine the incidence of withdrawal syndrome in children after continuous fentanyl and midazolam infusion.
  • To identify risk factors associated with the development of withdrawal syndrome.

Main Methods:

  • Retrospective cohort study in a pediatric intensive care unit.
  • Included 48 pediatric patients receiving continuous fentanyl and midazolam for at least 48 hours.
  • Collected data on demographics, drug doses, infusion duration, and withdrawal syndrome outcomes.

Main Results:

  • Withdrawal syndrome occurred in 50% of patients.
  • Significant risk factors included longer infusion duration and higher cumulative doses of fentanyl and midazolam.
  • Typical onset was 12-36 hours post-infusion, with mild to moderate severity. Methadone was the primary treatment.

Conclusions:

  • Continuous infusion of fentanyl and midazolam in children is associated with a high incidence of withdrawal syndrome.
  • Prolonged infusion duration and increased cumulative drug doses are significant risk factors.
Abstract

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