Opioid and benzodiazepine use during therapeutic hypothermia in encephalopathic neonates.,Journal of Perinatology

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Opioid and benzodiazepine use during therapeutic hypothermia in encephalopathic neonates.
Journal of Perinatology ( IF 2.4 ) Pub Date : 2019-10-15 , DOI: 10.1038/s41372-019-0533-4
Megan W Berube _{1,

2} , Monica E Lemmon _{2,

3,

4} , Carolyn E Pizoli ₂ , Margarita Bidegain ₂ , Veeral N Tolia ₅ , C Michael Cotten ₂ , Rachel G Greenberg _{2,

6}

Affiliation

OBJECTIVES To evaluate the use of sedatives and analgesics during therapeutic hypothermia in encephalopathic neonates and assess associations between medication exposure and hospital outcomes. STUDY DESIGN We identified neonates ≥35 weeks gestational age treated with therapeutic hypothermia at 125 neonatal intensive care units between 2007 and 2015. We compared characteristics and hospital outcomes between unexposed neonates and neonates exposed to opioids and/or benzodiazepines. RESULTS Opioids were administered to 1 677/2 621 (64%) neonates, and exposure increased from 38% in 2008 to 68% in 2015. Sedation/analgesia varied widely between centers. Opioid-exposed neonates experienced greater durations of respiratory support and were more likely to receive inotropes and inhaled nitric oxide. Mortality during postnatal days 0-3 was lower among opioid-exposed neonates (31/625 [5%]) than unexposed neonates (64/714 [9%]). CONCLUSIONS Sedation/analgesia during therapeutic hypothermia is prevalent but not uniform across centers. Prospective studies are needed to assess if exposure independently predicts intensity and duration of physiologic support.

中文翻译：

脑病性新生儿在治疗性体温过低期间使用阿片类药物和苯二氮卓类药物。

目的评估脑病新生儿在治疗性体温过低期间使用镇静剂和镇痛药的情况，并评估药物暴露与医院结局之间的关联。研究设计我们确定了2007年至2015年间在125个新生儿重症监护病房接受过低温治疗的孕龄≥35周的新生儿。我们比较了未暴露的新生儿和暴露于阿片类药物和/或苯二氮卓类的新生儿的特征和住院结局。结果对1 677/2 621（64％）新生儿使用了阿片类药物，其接触率从2008年的38％增加到2015年的68％。镇静/镇痛在各中心之间差异很大。接触阿片类药物的新生儿呼吸支持时间更长，并且更有可能接受正性肌力药和吸入一氧化氮。在阿片类药物暴露的新生儿中，出生后0-3天的死亡率（31/625 [5％]）低于未暴露的新生儿（64/714 [9％]）。结论治疗性体温过低时镇静/镇痛普遍存在，但各中心间镇静/镇痛并不统一。需要进行前瞻性研究来评估暴露是否独立地预测生理支持的强度和持续时间。

更新日期：2019-10-16

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