| Weaning of opioids and benzodiazepines at home after critical illness in infants: a cost-effective approach. | |
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MedLine Citation:
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PMID: 20297615 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To evaluate the feasibility of infants' weaning of opioids and sedatives at home. DESIGN: Retrospective observational study. SETTING: Level 3 pediatric intensive care unit. PATIENTS: Neonates treated for congenital diaphragmatic hernia (CDH) with extra corporeal membrane oxygenation (ECMO). INTERVENTION: Eligible infants were discharged early and further weaned of analgesics and/or sedatives at home. RESULTS: Of the 30 neonates treated for CDH with ECMO from 2003 to 2005, 15 survived. Five of these were weaned at home, on the guidance of telephone contact once a week. The mean infusion rates of morphine and midazolam for these children were significantly higher than those for other infants. Weaning at home took 11, 42, 107, 173, and 180 days, respectively, in the resultant mean savings on hospitalization costs per patient amounted to Euro150, 000. CONCLUSIONS: The results indicate that home weaning reduced the length of hospital stay by a median of 107 days for the five infants in this study, and thereby considerably reduced healthcare costs. Parents need to be informed clearly about possible withdrawal symptoms and should consent in this strategy. The strategy of final weaning with the aid of weekly telephone consultations with a consultant pediatric intensivist was feasible for these parents. |
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Authors:
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Erwin Ista; Monique van Dijk; Saskia Gischler; Mirjam de Leeuw; Marten J Poley; Dick Tibboel |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: Journal of opioid management Volume: 6 ISSN: 1551-7489 ISO Abbreviation: J Opioid Manag Publication Date: 2010 Jan-Feb |
Date Detail:
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Created Date: 2010-03-19 Completed Date: 2010-04-20 Revised Date: 2012-07-13 |
Medline Journal Info:
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Nlm Unique ID: 101234523 Medline TA: J Opioid Manag Country: United States |
Other Details:
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Languages: eng Pagination: 55-62 Citation Subset: IM |
Affiliation:
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Department of Intensive Care, Erasmus MC - Sophia Children's Hospital, Rotterdam, The Netherlands. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Analgesics, Opioid
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administration & dosage,
economics* Benzodiazepines / administration & dosage, economics* Cost-Benefit Analysis Critical Illness / economics, therapy* Female Follow-Up Studies Home Care Services / economics* Humans Infant, Newborn Intensive Care Units, Neonatal / economics* Male Retrospective Studies Weaning* |
| Chemical | |
Reg. No./Substance:
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0/Analgesics, Opioid; 12794-10-4/Benzodiazepines |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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