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DC Field | Value | Language |
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dc.contributor | Sistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP | |
dc.contributor.author | BICHAFF, Pedro | |
dc.contributor.author | SETANI, Karina T. | |
dc.contributor.author | MOTTA, Emiliana H. G. | |
dc.contributor.author | DELGADO, Artur F. | |
dc.contributor.author | CARVALHO, Werther B. | |
dc.contributor.author | LUGLIO, Michele | |
dc.date.accessioned | 2019-01-17T13:35:20Z | - |
dc.date.available | 2019-01-17T13:35:20Z | - |
dc.date.issued | 2018 | |
dc.identifier.citation | REVISTA DA ASSOCIACAO MEDICA BRASILEIRA, v.64, n.10, p.909-915, 2018 | |
dc.identifier.issn | 0104-4230 | |
dc.identifier.uri | https://observatorio.fm.usp.br/handle/OPI/30020 | - |
dc.description.abstract | OBJECTIVE: Opioid abstinence syndrome is common in the pediatric intensive care environment because sedation is often needed during the children's treatment. There is no specific guideline regarding the management of these patients; and lately, methadone is an important drug for the prevention of abstinence symptoms during the weaning of opioids. This study gathers the available research to establish the initial dose of methadone, the rate of taper and tools to recognize this syndrome and act promptly. METHODS: A systematic review was made from data of four different databases. Forty-nine articles of observational and experimental studies were selected based on the inclusion criteria (critical pediatric patients in acute use of opioids) and exclusion criteria (previous chronic use of opioids, other medications). The data regarding specific themes were separated in sections: initial dose of methadone, use of protocols in clinical practice, abstinence scales and adjuvant drugs. RESULTS: The articles showed a great heterogeneity of ways to calculate the initial dose of methadone. The pediatric intensive care units of the study had different weaning protocols, with a lower incidence of abstinence when a pre-defined sequence of tapering was used. The Withdrawal Assessment Tool - 1 was the most used scale for tapering the opioids, with good sensitivity and specificity for signs and symptoms. CONCLUSION: There is still little evidence of other medications that can help prevent the abstinence syndrome of opioids. This study tries to promote a better practice during opioid weaning. | eng |
dc.language.iso | eng | |
dc.publisher | ASSOC MEDICA BRASILEIRA | eng |
dc.relation.ispartof | Revista da Associacao Medica Brasileira | |
dc.rights | openAccess | eng |
dc.subject | Review | eng |
dc.subject | Critical Care | eng |
dc.subject | Analgesics, Opioid | eng |
dc.subject | Child | eng |
dc.subject | Substance Withdrawal Syndrome | eng |
dc.subject.other | withdrawal symptoms | eng |
dc.subject.other | abstinence syndrome | eng |
dc.subject.other | ill children | eng |
dc.subject.other | methadone | eng |
dc.subject.other | sedation | eng |
dc.subject.other | management | eng |
dc.subject.other | tolerance | eng |
dc.subject.other | analgesia | eng |
dc.subject.other | fentanyl | eng |
dc.subject.other | detoxification | eng |
dc.title | Opioid tapering and weaning protocols in pediatric critical care units: a systematic review | eng |
dc.type | article | eng |
dc.rights.holder | Copyright ASSOC MEDICA BRASILEIRA | eng |
dc.identifier.doi | 10.1590/1806-9282.64.10.909 | |
dc.identifier.pmid | 30517238 | |
dc.subject.wos | Medicine, General & Internal | eng |
dc.type.category | review | eng |
dc.type.version | publishedVersion | eng |
hcfmusp.description.beginpage | 909 | |
hcfmusp.description.endpage | 915 | |
hcfmusp.description.issue | 10 | |
hcfmusp.description.volume | 64 | |
hcfmusp.origem | WOS | |
hcfmusp.origem.id | WOS:000451927800009 | |
hcfmusp.origem.id | 2-s2.0-85057714729 | |
hcfmusp.origem.id | SCIELO:S0104-42302018001000909 | |
hcfmusp.publisher.city | SAO PAULO | eng |
hcfmusp.publisher.country | BRAZIL | eng |
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dc.description.index | MEDLINE | eng |
hcfmusp.citation.scopus | 5 | - |
hcfmusp.scopus.lastupdate | 2024-02-23 | - |
Appears in Collections: | Artigos e Materiais de Revistas Científicas - FM/MPE Artigos e Materiais de Revistas Científicas - HC/ICr Artigos e Materiais de Revistas Científicas - HC/InCor Artigos e Materiais de Revistas Científicas - LIM/36 |
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