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.
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: Margaret S Herridge; Angela M Cheung; Catherine M Tansey; Andrea Matte-Martyn; Natalia Diaz-Granados; Fatma Al-Saidi; Andrew B Cooper; Cameron B Guest; C David Mazer; Sangeeta Mehta; Thomas E Stewart; Aiala Barr; Deborah Cook; Arthur S Slutsky Journal: N Engl J Med Date: 2003-02-20 Impact factor: 91.245
Authors: Stéphane Leteurtre; Alain Martinot; Alain Duhamel; François Proulx; Bruno Grandbastien; Jacques Cotting; Ronald Gottesman; Ari Joffe; Jurg Pfenninger; Philippe Hubert; Jacques Lacroix; Francis Leclerc Journal: Lancet Date: 2003-07-19 Impact factor: 79.321
Authors: Christopher S Parshuram; Geraldine Y T Ng; Tommy K L Ho; Julia Klein; Aideen M Moore; Desmond Bohn; Gideon Koren Journal: Crit Care Med Date: 2003-10 Impact factor: 7.598
Authors: Dingwei Dai; James A Feinstein; Wynne Morrison; Athena F Zuppa; Chris Feudtner Journal: Pediatr Crit Care Med Date: 2016-05 Impact factor: 3.624