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Ann Pharmacother. 1996 Jan;30(1):27-30.

Steady-state plasma concentrations of midazolam in critically ill infants and children.

Author information

1
Institute of Child Health, Alder Hey Children's Hospital, Liverpool, England.

Abstract

OBJECTIVE:

To determine the steady-state plasma concentrations of midazolam in critically ill infants and children.

DESIGN:

Prospective uncontrolled study conducted over 18 months.

SETTING:

Regional pediatric intensive care unit in a children's hospital.

PATIENTS:

Thirty-eight infants and children, aged 1 month to 13 years, requiring midazolam as sedation during mechanical ventilation. The patients were divided into three age groups: (1) infants less than 12 months (n = 16); (2) children 1-2 years (n = 12); and (3) children aged 3 years and older (n = 10).

MAIN OUTCOME MEASURES:

A single blood sample was collected once steady-state plasma concentrations of midazolam were achieved during a continuous intravenous infusion. Plasma clearance was calculated from the plasma concentrations and infusion rate.

RESULTS:

The plasma clearance was higher in children aged 3 years and older (median plasma clearance 13.0 mL/min/kg) than in infants and children 1-2 years old (median plasma clearance 3.1 and 2.3 mL/min/kg, respectively) (Kruskal-Wallis analysis of variance, p < 0.01). The midazolam infusion rates were similar for the three groups studied (Kruskal-Wallis analysis of variance, p > 0.05). The plasma concentrations of midazolam were significantly lower in children 3 years and older (median plasma concentration 128 ng/mL) than in infants and children 1-2 years old (median plasma concentrations 395 and 790 ng/mL, respectively) (Kruskal-Wallis analysis of variance, p < 0.05).

CONCLUSIONS:

The plasma clearance in children 3 years and older was higher than in infants and children up to 2 years old. There was considerable interindividual variation in the steady-state plasma concentrations of midazolam in critically ill infants and children.

PMID:
8773161
DOI:
10.1177/106002809603000104
[Indexed for MEDLINE]

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