Withdrawal from multiple sedative agent therapy in an infant: Is dexmedetomidine the cause or the cure?

Pediatric Critical Care Medicine

Volumn 11, Issue 1, 2010, Pages

  Darnell, Cindy ^a   Steiner, Jeff ^a   Szmuk, Peter ^a   Sheeran, Paul ^a  

^a UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER   (United States)

Author keywords

Alpha 2 adrenergic agonist; Critically ill children; Sedation; Withdrawal symptoms

Indexed keywords

ALPHA ADRENERGIC RECEPTOR STIMULATING AGENT; DEXMEDETOMIDINE;

ARTICLE; ARTIFICIAL VENTILATION; CASE REPORT; HOSPITAL; HUMAN; INFANT; NEWBORN INTENSIVE CARE; WITHDRAWAL SYNDROME;

ADRENERGIC ALPHA-AGONISTS; DEXMEDETOMIDINE; HOSPITALS, PEDIATRIC; HUMANS; INFANT; INTENSIVE CARE UNITS, NEONATAL; SUBSTANCE WITHDRAWAL SYNDROME; VENTILATOR WEANING;

EID: 75149119778     PISSN: 15297535     EISSN: 19473893     Source Type: Journal    
DOI: 10.1097/PCC.0b013e3181a66131     Document Type: Article

References (19)

1. Tobias JD: Tolerance, withdrawal, and physical dependency after long-term sedation and analgesia of children in the pediatric intensive care unit. Crit Care Med 2000; 28:2122-2132 (Pubitemid 30428787)
2. Szumita PM, Baroletti SA, Anger KE, et al: Sedation and analgesia in the intensive care unit: Evaluating the role of dexmedetomidine. Am J Health Syst Pharm 2007; 64:37-44 (Pubitemid 46395706)
3. Tobias JD: Dexmedetomidine: Applications in pediatric critical care and pediatric anesthesiology. Pediatr Crit Care Med 2007; 8:115-131 (Pubitemid 46568561)
4. Ambuel B, Hamlett KW, Marx CM, et al: Assessing distress in pediatric intensive care environments: The COMFORT scale. J Pediatr Psychol 1992; 17:95-109
5. Finnegan LP, Connaughton JF Jr, Kron RE, et al: Neonatal abstinence syndrome: Assessment and management. Addict Dis 1975; 2:141-158
6. Cunliffe M, McArthur L, Dooley F: Managing sedation withdrawal in children who undergo prolonged PICU admission after discharge to the ward. Paediatr Anaesth 2004; 14:293-298 (Pubitemid 38534981)
7. Ista E, van Dijk M, Gamel C, et al: Withdrawal symptoms in children after long-term administration of sedatives and/or analgesics: A literature review. "Assessment remains troublesome." Intensive Care Med 2007; 33:1396-1406 (Pubitemid 47101702)
8. Suresh S, Anand KJ: Opioid tolerance in neonates: A state-of-the-art review. Paediatr Anaesth 2001; 11:511-521 (Pubitemid 34209026)
9. Geyskes GG, Boer P, Dorhout Mees EJ: Clonidine withdrawal. Mechanism and frequency of rebound hypertension. Br J Clin Pharmacol 1979; 7:55-62 (Pubitemid 9096746)
10. Weber MD, Thammasitboon S, Rosen DA: Acute discontinuation syndrome from dexmedetomidine after protracted use in a pediatric patient. Paediatr Anaesth 2008; 18:87-88 (Pubitemid 350264601)
11. Yaster M, Kost-Byerly S, Berde C, et al: The management of opioid and benzodiazepine dependence in infants, children, and adolescents. Pediatrics 1996; 98:135-140 (Pubitemid 26226991)
12. Meyer MM, Berens RJ: Efficacy of an enteral 10-day methadone wean to prevent opioid withdrawal in fentanyl-tolerant pediatric intensive care unit patients. Pediatr Crit Care Med 2001; 2:329-333
13. Farrell M: Opiate withdrawal. Addiction 1994; 89:1471-1475 (Pubitemid 24343907)
14. Tobias JD: Dexmedetomidine to treat opioid withdrawal in infants following prolonged sedation in the pediatric ICU. J Opioid Manag 2006; 2:201-205
15. Baddigam K, Russo P, Russo J, et al: Dexmedetomidine in the treatment of withdrawal syndromes in cardiothoracic surgery patients. J Intensive Care Med 2005; 20:118-123 (Pubitemid 43093903)
16. Finkel JC, Elrefai A: The use of dexmedetomidine to facilitate opioid and benzodiazepine detoxification in an infant [table of contents]. Anesth Analg 2004; 98:1658-1659 (Pubitemid 38668910)
17. Wright SW: Pertussis infection in adults. South Med J 1998; 91:702-708, quiz 709
18. Bhana N, Goa KL, McClellan KJ: Dexmedetomidine. Drugs 2000; 59:263-268; discussion 269-270 (Pubitemid 30168513)
19. Katz R, Kelly HW, Hsi A: Prospective study on the occurrence of withdrawal in critically ill children who receive fentanyl by continuous infusion. Crit Care Med 1994; 22: 763-767 Pediatr (Pubitemid 24151067)