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Opioid and sedative use in extremely preterm infants receiving mechanical ventilation
Zoe Henderson1, Grace Fuller2, Daniel K Benjamin3
1School of Medicine, University of New Mexico, Albuquerque, NM, USA.
Summary
Opioid and sedative use is common in mechanically ventilated preterm infants. High-frequency ventilation, compared to conventional, significantly increases the odds of medication exposure, highlighting a need for optimized respiratory support strategies.
Area of Science:
- Neonatal Medicine
- Pediatric Critical Care
- Pharmacology
Background:
- Mechanical ventilation is frequently required for preterm infants.
- Opioid and sedative medications are often administered to these vulnerable patients.
- Understanding medication exposure patterns is crucial for optimizing care.
Purpose of the Study:
- To quantify the exposure of preterm infants to specific opioid and sedative medications.
- To investigate the association between respiratory support methods and medication administration.
Main Methods:
- A cohort study included infants born <28 weeks' gestation requiring mechanical ventilation.
- Medication exposures (morphine, fentanyl, midazolam, lorazepam) were analyzed.
- Logistic regression examined the link between daily respiratory support and medication probability.
Main Results:
- 42% of 36,067 infants received at least one medication.
- Fentanyl and benzodiazepine exposure decreased from 2012 to 2020.
- High-frequency ventilation days had >2x the odds of medication administration compared to conventional ventilation.
Conclusions:
- Opioid and sedative use is prevalent in preterm infants on mechanical ventilation.
- High-frequency mechanical ventilation is associated with increased medication exposure.
- Further research into respiratory support optimization and its impact on sedation/analgesia is warranted.
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