Document Detail


Pharmacotherapy in pediatric critical illness: a prospective observational study.
MedLine Citation:
PMID:  19725598     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND OBJECTIVES: Pharmacotherapy is an under-evaluated element of critical care medicine. In order to better understand pharmacotherapy in pediatric critical illness, we evaluated a cohort of emergency admissions to a university-affiliated pediatric intensive care unit (PICU). METHODS: A prospective, observational study was performed. Eligible patients were admitted to this medical-surgical ICU for at least 24 hours. The primary outcomes were the number of drug orders written, the number of different medications ordered, and the number of drug administrations. Multiple regression analyses were used to identify factors independently associated with each primary outcome. RESULTS: We studied 100 patients with a median age of 40 months (interquartile range [IQR] 9-82), who were admitted for a total of 851 ICU days. These patients received 4419 drug orders and 11 911 intermittent dose-administrations of 241 different medications. Each patient received a median of 29.5 (IQR 16.5-48.5) drug orders, 14 (IQR 9-18.5) different medications, and 58 (IQR 28-129) drug administrations while in the ICU. The most frequent orders were for morphine 457 (10.6%), furosemide (frusemide) 337 (7.8%), potassium 237 (5.5%), lorazepam 226 (5.2%), and albuterol (salbutamol) 158 (3.7%). The duration of PICU stay and severity of illness were independently associated with all primary outcomes. CONCLUSIONS: Pharmacotherapy is an active component in the practice of pediatric critical care medicine. We demonstrated that increasing numbers of ordered medications, drug orders, and drug administrations were associated with increasing duration of ICU therapies and the length of ICU stay. These data underscore the potential importance of improved safety and efficacy of medicines used to treat critically ill children.
Authors:
Conor McDonnell; Stanley Hum; Helena Frndova; Christopher S Parshuram
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Paediatric drugs     Volume:  11     ISSN:  1174-5878     ISO Abbreviation:  Paediatr Drugs     Publication Date:  2009  
Date Detail:
Created Date:  2009-09-03     Completed Date:  2009-11-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100883685     Medline TA:  Paediatr Drugs     Country:  New Zealand    
Other Details:
Languages:  eng     Pagination:  323-31     Citation Subset:  IM    
Affiliation:
Department of Critical Care Medicine, Hospital for Sick Children, University of Toronto, Ontario, Canada.
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MeSH Terms
Descriptor/Qualifier:
Child
Child, Preschool
Critical Illness
Hospitals, Pediatric
Humans
Infant
Intensive Care Units, Pediatric
Length of Stay
Pharmaceutical Preparations / administration & dosage*,  adverse effects
Physician's Practice Patterns / statistics & numerical data*
Prospective Studies
Regression Analysis
Severity of Illness Index
Chemical
Reg. No./Substance:
0/Pharmaceutical Preparations

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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