| Autor: |
Papadaki, Marielena, Pratikaki, Maria, Giannopoulos, Achilleas, Ntaidou, Theodora, Mizi, Eleftheria, Kougias, Marios, Bouboulis, Georgios, Sarri, Aikaterini, Vrettou, Charikleia S. |
| Předmět: |
|
| Zdroj: |
Hospital Chronicles; 2019, Vol. 14 Issue 2, p48-53, 6p |
| Abstrakt: |
BACKROUND: Continuous infusion of midazolam is related to prolonged activity and delayed awakening in the critically ill. Serum midazolam levels can be helpful in differentiating residual benzodiazepine activity from other causes of impaired level of consciousness (LOC). Although drug levels can also be measured in the urine, the relationship between serum and urine levels with the observed LOC has not been studied in clinical practice. OBJECTIVES: To investigate the correlation between serum and urine midazolam levels in the critically ill and their correlation with the observed level of consciousness estimated with the Glasgow Coma Scale (GCS) and the Full Outline of UnResponsiveness Score (FOUR score). PATIENTS AND METHODS: This is a prospective observational study involving patients admitted to a 30 bed General Intensive Care Unit (ICU), who were intubated and mechanically ventilated, with GCS prior to intubation >8. Midazolam infusion was discontinued for at least 12 hours before sampling. Serum and urine sampling to measure midazolam levels and clinical evaluation to calculate the GCS and FOUR score were done simultaneously. RESULTS: Twenty patients fulfilled the inclusion criteria and participated in the study. Serum midazolam levels correlated moderately with the GCS (R =-0.496, p=0.026) and better with the FOUR score (R =-0.685, p=0.001), but did not correlate with measured levels in the urine (R =-0.029 p=0.904). CONCLUSIONS: After discontinuation of midazolam sedation, the LOC correlate significantly with the drug levels in the serum. Urine midazolam levels do not correlate with those measured in the serum or with the observed LOC. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
| Externí odkaz: |
|
