Pharmacokinetics of continuous infusions of fentanyl in critically ill children

Title

Pharmacokinetics of continuous infusions of fentanyl in critically ill children

Creator

Katz R; Kelly HW

Publisher

Critical Care Medicine

Date

1993

Subject

adolescent; Child; Humans; infant; Male; Critical Illness; Prospective Studies; Fentanyl; Half-Life; Preschool; Newborn; Infusions; Intravenous; Metabolic Clearance Rate

Description

OBJECTIVE: To determine the pharmacokinetics of fentanyl when used as a long-term continuous infusion for sedation/analgesia in mechanically ventilated critically ill infants and children. DESIGN: Prospective, case series. SETTING: A university hospital pediatric intensive care unit (ICU). PATIENTS: Nineteen mechanically ventilated infants and children (0.05 to 14 yrs of age) who received continuous infusions of fentanyl for > 24 hrs. INTERVENTIONS: None. MEASUREMENTS: Plasma concentrations of fentanyl were measured 1 hr after a loading dose and at various intervals during and after the infusions were discontinued. Noncompartmental pharmacokinetic variables, total body clearance, volume of distribution at steady state, and terminal elimination half-life were calculated. Clinical sedation scores, ventilatory settings, pupillary size and reactivity, and patient demographics were recorded. RESULTS: After the use of fentanyl by long-term infusion, the volume of distribution at steady state was increased 15.2 L/kg (range 5.1 to 30.5) and the terminal elimination half-life was prolonged 21.1 hrs (range 11.2 to 36.0) compared with previous studies. Clearance was rapid and consistent with other studies. There was a large interpatient variability in clearance that was age dependent. Clearance did not appear to increase over time. CONCLUSIONS: Total body clearance of fentanyl is highly variable and it should be dosed to effect. Patients seen in a pediatric ICU may require a ten-fold variability in fentanyl infusion rates to achieve similar levels of sedation.
1993-07

Rights

Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).

Type

Journal Article

Citation List Month

Backlog

Pages

995-1000

Issue

7

Volume

21

Citation

Katz R; Kelly HW, “Pharmacokinetics of continuous infusions of fentanyl in critically ill children,” Pediatric Palliative Care Library, accessed July 31, 2021, https://pedpalascnetlibrary.omeka.net/items/show/12013.

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