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Pharmacological sedation management in the paediatric intensive care unit

Manuel A Baarslag1, Karel Allegaert1,2, Catherijne A J Knibbe3,4

  • 1Intensive Care and Department of Pediatric Surgery, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands.

The Journal of Pharmacy and Pharmacology
|August 23, 2016
PubMed

Insights

Optimal pediatric sedation management requires more research due to scarce evidence. This review highlights ongoing studies and advanced methods to improve sedative strategies for critically ill children.

Area of Science:

  • Pediatric Intensive Care
  • Pharmacology
  • Clinical Research

Background:

  • Sedation management in pediatric intensive care units (PICUs) lacks optimal evidence-based strategies.
  • Commonly used sedatives and their pharmacokinetic/pharmacodynamic profiles in children require further elucidation.

Purpose of the Study:

  • To review current knowledge on pediatric sedation management, identify knowledge gaps, and discuss ongoing research.
  • To provide an overview of sedatives, their properties, guidelines, and assessment methods in pediatric critical care.

Main Methods:

  • Literature review of sedation management in PICUs.
  • Analysis of pharmacokinetic and pharmacodynamic data for pediatric sedatives.
  • Examination of current sedation guidelines and assessment tools.

Main Results:

  • Evidence and pharmacokinetic data for pediatric sedatives are scarce.
  • Active research is generating new pharmacokinetic (PK) and pharmacodynamic (PD) data for pediatric sedatives.
  • Regulatory bodies like the FDA and EMA recognize the need for improved evidence.

Conclusions:

  • The heterogeneous nature of the pediatric population necessitates a move towards evidence- or model-based sedation practices.
  • Future research should focus on sedation assessment and the implementation of protocolized sedation strategies.
  • Improvements in pediatric sedation extend beyond pharmacology, encompassing assessment and implementation strategies.
Abstract

Keywords:
critical carepaediatricspharmacodynamicspharmacokineticssedation

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