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Published on: January 7, 2020
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Melatonin Use in Infants Admitted to Intensive Care Units
Caitlyn Bradford1, Jamie L Miller2, Maura Harkin3
1Department of Pharmacy Practice (CB), Philadelphia College of Pharmacy, Saint Joseph's University, Philadelphia, PA.
Summary
This study found melatonin is safe for infants in intensive care, primarily for sleep promotion. While it reduced opioid use, it did not improve pain or sedation scores in this infant population.
Area of Science:
- Pediatric Intensive Care
- Neonatal Pharmacology
- Sleep Medicine
Background:
- Sleep deprivation is a significant risk factor for delirium in intensive care units (ICUs).
- Melatonin is utilized for delirium prevention and treatment, but data on its safety and efficacy in infants is limited.
- Understanding melatonin's role in infant care is crucial for optimizing treatment strategies.
Purpose of the Study:
- To investigate the indications, dosing, efficacy, and safety of melatonin use in infants admitted to the ICU.
- To address the gap in knowledge regarding melatonin administration in this vulnerable patient population.
Main Methods:
- A descriptive, retrospective study involving infants under 12 months old who received melatonin in the ICU.
- Data collected included patient demographics, melatonin regimens, and concurrent sedative, analgesic, and antipsychotic medications.
- Statistical analyses, including Wilcoxon signed rank tests and linear mixed models, were used to assess outcomes.
Main Results:
- Fifty-five infants were included, with the primary indication for melatonin being sleep promotion (52.7%).
- The median weight-based dose was 0.31 mg/kg/dose.
- A statistically significant reduction in cumulative opioid dosing was observed post-melatonin initiation (p = 0.049), though pain and sedation scores did not improve.
Conclusions:
- Melatonin is commonly used for sleep promotion in infants within the ICU setting at a median dose of 0.31 mg/kg/dose.
- Initiating melatonin was associated with decreased opioid exposure in infants.
- Further research is needed as melatonin did not demonstrate a significant impact on pain or sedation scores in this study cohort.
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