相关实验视频
Updated: Jan 8, 2026

11:19
Guidelines for Elective Pediatric Fiberoptic Intubation
Published on: January 17, 2011
18.3K
芬太尼在体外膜氧化治疗的儿童中使用的机构变化
Rabab M Barq1,2, Shadassa Ourshalimian1, Olivia A Keane1,2
1Division of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, California.
Hospital pediatrics
|December 17, 2025
概括
尽管存在风险,但芬太尼通常用于治疗身体外膜氧化 (ECMO) 的危急儿童. 新生儿和患有心血管疾病的儿童使用芬太尼的比例较高,强调需要更好的疼痛管理指南.
科学领域:
- 儿科重症监护医学 儿科重症监护医学
- 药理学 药理学是指药理学的学科.
- 新生儿科学 新生儿科学
背景情况:
- 芬太尼是一种阿片类止痛药,经常用于治疗重症儿童的疼痛.
- 在体外膜氧化 (ECMO) 期间使用它是谨慎的,因为它的脂性质增加了戒断风险.
- 了解儿科ECMO患者使用芬太尼的机构变化至关重要.
研究的目的:
- 为了评估在接受ECMO的儿童 fentanyl 管理的机构变化.
- 确定与这种脆弱人群中的芬太尼尔处方模式相关的因素.
主要方法:
- 从2016年到2023年对ECMO使用的儿童 (<18岁) 的回顾性研究.
- 数据来源于儿科健康信息系统.
- 多变量层次逻辑回归分析了与芬太尼使用相关的因素.
主要成果:
- 在7731名儿童中,91.9%的儿童在ECMO期间接受了芬太尼,有显著的机构变化 (13.4%-100%).
- 医院差异占芬太尼使用变化的20.3%.
- 新生儿 (OR 2.35) 和患有心血管疾病的儿童 (OR 1.63) 的芬太尼使用几率较高;早产婴儿的几率较低 (OR 0.50).
结论:
- 芬太尼在儿科ECMO中仍然普遍存在,尽管存在已知的风险.
- 芬太尼的使用存在显著的机构差异,新生儿是最容易暴露的.
- 迫切需要加强儿科ECMO镇静和疼痛管理的指导方针.
相关概念视频
Parenteral Anesthetics: Overview
541
Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
541
Drug Dosing: Infants and Children
231
Pediatric patient dosages diverge from adults due to disparities in body surface area, total body water, and extracellular fluid per kilogram of body weight. The dosing regimen considers the variations in pharmacokinetics and pharmacology across distinct age groups, encompassing preterm newborns, infants, young children, older children, and adolescents. Calculation of pediatric patient doses is predicated on determining body surface area, which exhibits a superior correlation with the child's...
231
Pharmacokinetics in Pediatric Patients: Drug Excretion
194
In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
194
Pharmacokinetics in Pediatric Patients: Drug Distribution
240
Drug distribution in the pediatric population exhibits unique challenges and considerations due to the physiological differences between children, particularly neonates and infants, and adults. A crucial aspect of pediatric pharmacology is understanding how these differences impact the pharmacokinetics of various drugs, necessitating age-specific dosing strategies to ensure efficacy and safety.Neonates and infants have a higher total body water content, ~75%–90% of their body weight,...
240
Drug Delivery: Enteral Route
1.5K
The enteral drug administration involves three primary routes: oral, sublingual, and buccal. Oral ingestion is the most prevalent, safe, economical, and convenient method for drug administration. However, it has certain drawbacks, including limited absorption due to the drug's low water solubility or poor membrane permeability, possible emesis from GI mucosa irritation, destruction of drugs by digestive enzymes or low gastric pH, and irregular absorption along with food or other drugs.
1.5K
Extracorporeal Removal of Drugs: Continuous Renal Replacement Therapy
163
Continuous Renal Replacement Therapy (CRRT) is an essential intervention for patients experiencing severe kidney dysfunction. This therapy offers a continuous mechanism for removing fluids and toxins from the bloodstream, leveraging the patient’s blood pressure to facilitate filtration through a specialized filter. This method contrasts with intermittent dialysis, providing a gentler and more consistent removal of waste products and excess fluid, which is particularly beneficial in...
163

