Pharmacokinetics of sedatives – Understanding a modifiable risk factor for pediatric delirium

镇静剂的药代动力学 — 了解小儿谵妄的可改变危险因素

基本信息

批准号：
9803362
负责人：
MICHAEL J BELL
金额：
$ 66.53万
依托单位：
CHILDREN'S RESEARCH INSTITUTE
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-09-01 至 2024-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9803362
关键词：
Acute Acute respiratory failure Adult Affect Age Awareness Benzodiazepines Biological Assay Buffaloes Caring Child Childhood Clinical Clinical Research Complex Critical Care Critical Illness Critically ill children Data Delirium Development Dexmedetomidine Dose Drug Kinetics Drug Modelings Etiology Fentanyl Functional disorder Future Health Care Costs Healthcare Impaired cognition Incidence Institutes Lead Length of Stay Link Measures Mechanical ventilation Metabolism Midazolam Modeling Morbidity - disease rate Morphine Multicenter Studies Narcotics Neurologic Dysfunctions Opioid Outcome Patient Care Patients Pharmaceutical Preparations Pharmacology Population Positioning Attribute Prevention Procedures Property Psychiatrist Regimen Research Risk Risk Factors Role Screening procedure Sedation procedure Serum Structural Models Testing Time Universities base care burden care outcomes clinical care cognitive function cohort drug clearance experience modifiable risk mortality patient population pharmacokinetic model pharmacokinetics and pharmacodynamics prevent programs public health emergency response sedative

项目摘要

Project Summary/Abstract Over the past decade, delirium – identified as an unexplained alteration in cognitive function as a result of another clinical condition – has become recognized as a public health emergency for adults with critical illnesses. In this patient population, delirium is associated with mortality, morbidity, increased length of hospital stays and increased health care costs. We have developed a delirium screening tool to assess delirium in children of all ages. This score, the Cornell Assessment of Pediatric Delirium, has been validated with several psychiatrists at Cornell University and is starting to be used as a part of clinical care. While the development of delirium is multifactorial, sedatives represent a modifiable risk factor for clinicians to consider. To date, there is no pharmacokinetic information to guide clinicians on which sedatives are linked to delirium development. Based on extensive preliminary evidence, we suspect that benzodiazepine-based sedation is related to delirium development and may be affected by drug clearance and serum concentrations. We will also determine if other commonly used narcotics and other agents are associated with delirium development independent of benzodiazepine effects. We will test these two specific aims in a multi-centered (n = 3) study with analysis done at the University of Pittsburgh and University of Buffalo.

项目概要/摘要在过去的十年中，谵妄被认为是由于以下原因导致的认知功能的无法解释的改变：另一种临床病症——已被公认为危重成人的公共卫生紧急情况在该患者群体中，谵妄与死亡率、发病率和住院时间延长有关。我们开发了一种谵妄筛查工具来评估谵妄。该分数（康奈尔儿童谵妄评估）已得到多项验证。康奈尔大学的精神病学并开始被用作临床护理的一部分。谵妄是多因素造成的，镇静剂是忠诚者需要考虑的可改变的风险因素。没有药代动力学信息来指导上级哪些镇静剂与谵妄的发生有关。根据广泛的初步证据，我们怀疑基于苯二氮卓类的镇静作用与谵妄的发展也可能受到药物清除率和血清浓度的影响。确定其他常用麻醉剂和其他药物是否与谵妄的发生有关我们将在一项多中心（n = 3）研究中测试这两个具体目标。匹兹堡大学和布法罗大学进行了分析。