Document Type
Poster
Publication Date
4-13-2023
Abstract
Background: Pain medication use in the Newborn Intensive Care Unit (NICU) can be highly challenging due to concerns for negative impact on long-term neurodevelopmental outcomes. Many commonly utilized pain medications and sedatives such as midazolam, fentanyl, and morphine have problematic side effects, such as decreased gut motility, that can prolong time to full feeds and increase hospital length of stay. Additionally, there are associations with neurodevelopmental delays following exposures. There remains a paucity of data regarding possible alternative medications that may not have this side effect profile. Dexmedetomidine may be a safe alternative, although additional investigations are needed to determine which patient populations may safely receive this medication.
Methods: A retrospective chart review was performed of terms infants (≥37 weeks gestation) who were admitted to the NICU at the University of New Mexico Hospital (UNMH) from November 2019 – November 2021 and required utilization of continuous infusion of benzodiazepines and/or opioids.
Data: 133 infant charts were reviewed with demographics collected including gestational age, mode of delivery, length of hospital stay, and neonatal outcome. Information collected on medication exposure included the day of life that the benzodiazepine and/or opioid medication was started, the indication for medication initiation, the length of time medication was administered, the time the infant was not feeding during medication administration, and the time to full enteral feeds following medication initiation.
Conclusion: The findings from this population contributed to the current sedation and pain medication use in the UNMH NICU. With these findings, along with nationally published NICU research, a dexmedetomidine treatment guideline was developed and implemented in the UNMH NICU on 8/1/2022. We aim to prospectively collect data on infants receiving dexmedetomidine and compare outcomes with this retrospective chart review to determine if the use of dexmedetomidine in a term infant population can be safe and potentially shorten hospital length of stay.
Recommended Citation
Carrier, Austin; Dane G. Winter; Zoe Henderson; Jessica Gross; Eleni Shenk; and Jessie R. Maxwell. "Characterizing Current Sedation and Pain Medication Use in the Newborn Intensive Care Unit: Implications for Dexmedetomidine Guideline Development." (2023). https://digitalrepository.unm.edu/hsc_2023_pediatric_research/7
Comments
Poster presented at Pediatric Research Forum