A prospective study of the adverse effects of midazolam on withdrawal in critically ill children.
Fifty-three critically ill infants and children received midazolam as sedation in a regional intensive care unit. Assessment of the level of sedation was carried out at regular intervals on withdrawal of midazolam. Forty-nine patients were fully alert within 4 h of midazolam being stopped. Four patients took from 6 h to 1 week to become fully alert. Four patients had abnormal behaviour highly suggestive of midazolam withdrawal. The onset of abnormal behaviour was within 12 h of discontinuation of midazolam. The duration of the abnormal behaviour ranged from 3 h to 1 week. One child had a paradoxical reaction to midazolam. The overall incidence of adverse effects to midazolam in the patients studied was 17%. No adverse effects were observed in infants; all adverse effects were observed in children. We have shown that it is possible to prospectively study the toxicity of sedatives in critically ill infants and children.
Hughes
J
J
Institute of Child Health, Alder Hey Children's Hospital, Liverpool, UK.
Gill
A
A
Leach
H J
HJ
Nunn
A J
AJ
Billingham
I
I
Ratcliffe
J
J
Thornington
R
R
Choonara
I
I
D002648:Child; D002652:Child Behavior / Q000187:drug effects; D002675:Child, Preschool; D016638:Critical Illness / Q000628:therapy; D006212:Hallucinations / Q000139:chemically induced; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008874:Midazolam / Q000009:adverse effects*; D009460:Neurologic Examination; D011446:Prospective Studies; D012307:Risk Factors; D012894:Sleep Stages / Q000187:drug effects; D013375:Substance Withdrawal Syndrome / Q000175:diagnosis / Q000209:etiology*
D008874:Midazolam