在住院的早产婴儿中使用德克斯梅托米丁和阿片类药物
Samantha Curtis1, Ryan Kilpatrick1,2, Zeenia C Billimoria3
1Department of Pediatrics, Duke University Medical Center, Durham, North Carolina.
JAMA network open
|November 3, 2023
概括
在早产婴儿中非标签使用德克斯梅德托米丁的数量从2010年到2020年显著增加. 德克斯梅德托米丁使用的增加与这些易受伤害的婴儿中阿片类药物暴露的减少一致.
科学领域:
- 新生儿药理学 新生儿药理学
- 儿科重症监护室的重症监护室
- 上腺素受体激活剂
背景情况:
- 德克斯梅德托米丁是一种α2-上腺激动剂,在早产婴儿中越来越多地被非标签使用,尽管它没有被FDA批准用于这一群体.
- 在过去的十年中,美国新生儿重症监护室 (NICU) 的德克斯梅德托米丁使用量显著增加.
- 缺乏大规模研究来描述其使用情况,并将其与新生儿的阿片类药物进行比较.
研究的目的:
- 描述NICU中德克斯梅德托米丁的使用模式.
- 检查德克斯梅德托米丁和阿片类药物在早产婴儿中的使用之间的关联.
主要方法:
- 多中心观察队列研究 (2022年11月 - 2023年4月).
- 包括383个美国NICU中怀孕22周至36周之间出生的婴儿.
- 对2010年至2020年药物暴露数据的分析.
主要成果:
- 分析了395,122名婴儿;384名 (0.1%) 接受了德克斯梅德托米丁.
- 德克斯梅德托米丁的使用量从0.003% (2010) 增加到0.185% (2020) (P < .001).
- 对阿片类药物的暴露从8.5% (2010) 降至7.2% (2020) (P < .001).
- 接受德克斯梅德托米丁的婴儿更不成熟,出生体重更低,住院时间更长.
结论:
- 在早产婴儿中,德克斯梅德托米丁的使用显著增加,而阿片类药物的使用在2010年至2020年期间下降.
- 需要进一步的研究来评估德克斯梅德托米丁在这个人群中的短期和长期影响.
- 这些发现突显了新生儿重症监护中不断发展的药理学实践.
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