Category Ranking
98%
Total Visits
921
Avg Visit Duration
2 minutes
Citations
20
Article Abstract
Objectives: Intravenous midazolam is widely used for sedation in critically ill children. Sometimes, these children develop a paediatric delirium (PD). Our aim was to determine the relationship between midazolam serum concentration and the development of new PD in critically ill children.
Design: Prospective observational pilot study.
Setting: Paediatric Intensive Care Unit (PICU), Groningen, the Netherlands.
Patients: All children admitted to the PICU from October-December 2019 who received continuous midazolam administration.
Interventions: None.
Measurements And Main Results: Twenty-five percent (n = 7) of the included patients (n = 28) developed new PD. In most patients, PD occurred following midazolam dose reduction. The median cumulative midazolam dose was higher in patients who developed PD compared to those without PD. We analysed 104 blood samples to determine the midazolam concentrations. To determine whether patients had PD, the Sophia Observation withdrawal Symptoms-Paediatric Delirium (SOS-PD) score was used. Patients suffering PD (n = 7) had a lower median midazolam concentration on that day compared with the day prior to PD detection. Analysis of the active metabolites, 1-hydroxymidazolam and 1-hydroxymidazolam glucuronide, showed similar results.
Conclusions: PD may be linked to a sudden and significant reduction in the midazolam concentration in critically ill children. Further investigation in larger patient populations is necessary to validate our findings.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11755441 | PMC |
| http://dx.doi.org/10.3390/pediatric17010007 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
From clinical trials to daily practice: how to adequately administer sulbactam-durlobactam? alone or combined with imipenem?
Curr Opin Infect Dis
September 2025
Infectious Diseases Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna.
Purpose Of Review: Sulbactam-durlobactam (SUL-DUR) is a novel β-lactam/β-lactamase inhibitor combination recently approved for carbapenem-resistant Acinetobacter baumannii (CRAB) infections. This review summarizes current knowledge on the optimal use of SUL-DUR, whether administered alone or in combination with carbapenems, particularly imipenem.
Recent Findings: Data from registrational trial demonstrate that SUL-DUR is an effective and well tolerated treatment option for CRAB severe infections.
Pain, Agitation, Delirium, and Iatrogenic Withdrawal Syndrome Management in Children Who Are Critically Ill: Protocol for a European Clinical Practice Guideline Using the Grading of Recommendations Assessment, Development, and Evaluation Approach.
JMIR Res Protoc
September 2025
Institute of Higher Education and Research in Healthcare, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland.
Background: In pediatric intensive care units, pain, sedation, delirium, and iatrogenic withdrawal syndrome (IWS) must be managed as interrelated conditions. Although clinical practice guidelines (CPGs) exist, new evidence needs to be incorporated, gaps in recommendations addressed, and recommendations adapted to the European context.
Objective: This protocol describes the development of the first patient- and family-informed European guideline for managing pain, sedation, delirium, and IWS by the European Society of Paediatric and Neonatal Intensive Care.
Gonorrhea and Chlamydia Screening for Adolescents and Young Adults in Emergency Departments.
JAMA Pediatr
September 2025
Department of Pediatrics and Emergency Medicine, Children's National Hospital, George Washington University, Washington, DC.
Importance: Adolescents account for almost half of the 2.5 million diagnosed sexually transmitted infections in the US annually, and the emergency department functions as the primary source of health care for many adolescents. No recommendations exist for emergency department gonorrhea and chlamydia screening.
View Article and Find Full Text PDFCost-Effectiveness of In-Bed Cycling and Routine Physiotherapy for Patients Receiving Mechanical Ventilation.
JAMA Netw Open
September 2025
School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
Importance: The cost-effectiveness of adding early in-bed cycling to usual physiotherapy among adults receiving mechanical ventilation in the intensive care unit (ICU) compared with usual physiotherapy alone is unknown.
Objective: To evaluate the cost-effectiveness of in-bed cycling plus usual physiotherapy compared with usual therapy alone in the Critical Care Cycling to Improve Lower Extremity Strength (CYCLE) randomized clinical trial.
Design, Setting, And Participants: This trial-based economic evaluation with a 90-day time horizon compared early cycling plus usual physiotherapy vs usual physiotherapy alone from a societal perspective.
Ultrasound-Based Assessment of Rectus Femoris Muscle Wasting as a Predictor of 28-Day Mortality in Septic Shock: A Prospective Study.
J Intensive Care Med
September 2025
Medical Intensive Care Unit, 108 Military Central Hospital, Hanoi, Vietnam.
Background: Bedside ultrasound is increasingly utilized to assess muscle mass in critically ill patients, providing a noninvasive and real-time tool for early risk stratification. Muscle wasting is known to be associated with adverse outcomes in septic shock, but its prognostic value using ultrasound in this population remains underexplored. This study aimed to investigate the association between changes in rectus femoris cross-sectional area (CSA), assessed by bedside ultrasound, and 28-day mortality in patients with septic shock.
View Article and Find Full Text PDF