Evidence · Research paper
Supporting clinical guidelines for opioid conversion to methadone and tapering to prevent withdrawal in critically ill children using physiology based pharmacokinetic modeling and simulation.
- Medical
- Nursing
- Pain management
- Sedation
- Sedation and analgesia
Summary
This study uses physiologically-based pharmacokinetic modelling and expert panel consensus to derive schedules for converting fentanyl or morphine infusions to methadone and subsequently tapering it in critically ill children. Simulations compared predicted methadone plasma concentrations against therapeutic targets for various conversion ratios and published tapering protocols. The resulting consensus recommendations have been incorporated into the Dutch Pediatric Formulary. Relevant to PICU teams managing iatrogenic opioid withdrawal after prolonged sedation and analgesia.
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- Licence:
- Open (Creative Commons)
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