治疗性低温期间的德克斯梅德托米丁:一个多中心质量倡议
Megan Elliott1, Karen Fairchild1, Santina Zanelli1
1Division of Neonatology, Department of Pediatrics, University of Virginia Children's Hospital, Charlottesville, Virginia.
Hospital pediatrics
|December 20, 2023
概括
这项质量改进计划通过将德克斯米德胺作为主要镇静剂,成功地将新生儿治疗性低温 (TH) 期间的阿片类药物暴露量减少了90%以上. 德克斯梅德托米丁在TH期间的镇静中被证明是安全和有效的.
科学领域:
- 新生儿医学 新生儿医学
- 药理学 药理学是指药理学的学科.
- 提高质量 提高科学 提高质量
背景情况:
- 在新生儿治疗性低温 (TH) 期间,镇静是标准的.
- 在TH期间使用阿片类药物可能会产生不良影响.
- 需要替代性镇静剂来尽量减少阿片类药物暴露.
研究的目的:
- 为了减少接受TH的新生儿的阿片类药物暴露.
- 在TH期间,将德克斯梅德托米丁作为主要镇静剂.
- 评估德克斯梅德托米丁在这个人群中的安全性和有效性.
主要方法:
- 进行了一项双中心质量改进 (QI) 倡议.
- 一个镇静算法被开发用于德克斯梅德米丁的实施.
- 统计过程控制图分析了阿片类药物暴露和安全参数的变化.
主要成果:
- 在TH期间累积的阿片类药物暴露减少了90%以上.
- 德克斯梅德托米丁的启动合规性达到了99%.
- 在9.6%的新生儿中,德克斯梅德托米丁因过渡性心肌梗塞而停止治疗,没有观察到其他不良影响.
结论:
- 在新生儿TH期间,德克斯梅德托米丁可以安全地用作主要镇静剂.
- 德克斯梅德托米丁的不良反应发生率很低.
- 需要进行进一步的临床试验,以评估TH期间镇静对神经学结果的影响.
相关概念视频
Decreased Body Temperature
620
A decreased body temperature can occur in patients with hypothermia and frostbite. Heat loss with extended cold exposure overpowers the body's ability to create heat, resulting in hypothermia. Core temperature readings help classify hypothermia. Mild hypothermia is temperatures between 32 °C (89.6 °F) and 35°C (95 °F) and is caused by impaired thermoregulation. Moderate hypothermia is temperatures between 28 C (82.4 °F) and 32 °C (89.6 °F) caused by...
620
Methods of reducing fever
666
The signs and symptoms of fever include hot and dry skin, flushed face, thirst, muscle aches, anorexia, headache, tachycardia, tachypnea, and fatigue. Elevated body temperature is reduced using two methods: pharmacological and nonpharmacological. Proper identification and treatment of the root cause of a fever is of utmost importance.
Pharmacological Methods of Reducing Fever:
Pharmacological Methods of Reducing Fever:
666
Sedatives and Hypnotics Drugs: Miscellaneous Agents
178
Sedatives and hypnotics encompass a wide range of substances, each with its unique mechanism of action, uses, and potential adverse effects.
Melatonin congeners like ramelteon (Rozerem) and tasimelteon (Hetlioz) selectively bind to melatonin receptors (MT1 and MT2) and thus mimic the actions of melatonin, a hormone that regulates sleep-wake cycles. Tasimelteon is primarily used for non-24-hour sleep-wake disorder, common in blind patients. They are also used to treat conditions like insomnia...
Melatonin congeners like ramelteon (Rozerem) and tasimelteon (Hetlioz) selectively bind to melatonin receptors (MT1 and MT2) and thus mimic the actions of melatonin, a hormone that regulates sleep-wake cycles. Tasimelteon is primarily used for non-24-hour sleep-wake disorder, common in blind patients. They are also used to treat conditions like insomnia...
178


