title: Continuous hydromorphone for pain and sedation in mechanically ventilated infants and children.
abstract: OBJECTIVE
  To describe dosing regimens and efficacy of continuous infusion hydromorphone in mechanically ventilated children.
  
  
  METHODS
  Retrospective review.
  
  
  METHODS
  Tertiary care, pediatric hospital.
  
  
  METHODS
  Ninety-two critically ill children (<18 years old).
  
  
  METHODS
  Hydromorphone dosing requirements, concomitant pain and sedation therapy, patient-specific pain scores (using Face Legs Activity Cry Consolability [FLACC] pain scale), and possible adverse drug events related to therapy.
  
  
  RESULTS
  Starting dose was 0.024 +/- 0.04 mg/kg/h. Maximum dose was 0.05 + 0.1 mg/kg/h. Duration of therapy was 182 +/- 169 hours. Most patients received additional pain and sedation therapy. Most mean daily FLACC scores (66 percent) were below 1. Less than 10 percent of scores were above 3; only 1 score was above 6. Mean FLACC score, when averaged per patient course, was 1.004 +/- 0.71. Extracorporeal membrane oxygenation (ECMO) patients had a significantly higher initial and maximum dosing requirement than non-ECMO patients (p = 0.001).
  
  
  CONCLUSIONS
  Continuous infusion hydromorphone appears to be an effective adjunctive analgesic in mechanically ventilated children.
authors.affiliation: Department of Pharmacy, Center for Pediatric Medicine, Children's Hospital Colorado, Aurora, Colorado, USA.
authors.forename: Pamela D
authors.initials: PD
authors.lastname: Reiter
authors.forename: Jennifer
authors.initials: J
authors.lastname: Ng
authors.forename: Emily L
authors.initials: EL
authors.lastname: Dobyns
mesh_terms: D000293:Adolescent; D000700:Analgesics / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D004091:Hydromorphone / Q000009:adverse effects / Q000627:therapeutic use*; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010146:Pain / Q000188:drug therapy*; D012121:Respiration, Artificial / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies
chemical_list: D000700:Analgesics; D004091:Hydromorphone