儿科重症监护室机械通风期间使用洛拉泽帕姆治疗疼痛
Paul Healy1, Marco Marano2, Marcello Montibeller2
1Clinical Pharmacology & Therapeutics Group, University College London, London, United Kingdom.
Frontiers in medicine
|February 9, 2026
概括
这项研究使用了药理动力学建模来确定儿科重症监护病房中疼痛坐位治疗的最佳洛拉泽帕姆剂量. 这些发现支持lorazepam作为机械通风儿童的安全和有效替代品.
科学领域:
- 药理学 药理学是指药理学的学科.
- 儿科重症监护 儿科重症监护
- 药理动力学 药理动力学
背景情况:
- 洛拉泽在儿科重症监护室 (PICU) 中用于非标签的疼痛治疗.
- 在需要机械通风的儿科患者中,对于最佳的洛拉泽帕姆剂量存在有限的证据.
- 药理动力学建模可以指导儿科患者的剂量策略.
研究的目的:
- 确定lorazepam的剂量方案,以在机械通风儿童中有效的疼痛镇静.
- 为了优化对洛拉泽帕姆疼痛镇静的前性临床试验的设计.
- 在儿科重症监护中建立lorazepam的基于证据的剂量.
主要方法:
- 使用了人口药理动力学模型,其中包含了六名儿科患者的数据.
- 在100名儿童 (1-12岁) 的虚拟队列中进行了临床试验模拟.
- 探索了间歇性玻尿酸和持续输液方案,目标是500 ng/ml的洛拉泽巴姆度.
主要成果:
- 药物动力学模型准确地描述了洛拉泽帕姆度-时间概况,具有个体间的变化.
- 模拟表明,间歇性注射每4小时一次,再加上连续输注,维持了目标度.
- 确定了初始玻尿酸注射 (0.2 mg/kg q4h) 的推方案,其次是较低的玻尿酸注射 (0.1 mg/kg q4h) 和持续输液 (0.03 mg/kg/h).
结论:
- 基于模型的方法对于在有限的数据基础上建立儿科剂量方案至关重要.
- 拟议的洛拉泽帕姆治疗方案平衡了儿科疼痛治疗的疗效和安全性.
- 这项研究为重新使用洛拉泽帕作为PICU设置中的二线疼痛治疗选择提供了基础.
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