Abstract P-470: EVALUATION OF IATROGENIC WITHDRAWAL FROM OPIOIDS AND BENZODIAZEPINES IN THE PEDIATRIC INTENSIVE CARE UNIT

Abstract

Aims & Objectives: Iatrogenic withdrawal syndrome (IWS) is common in pediatric intensive care unit (PICU). Main objective of this study was to assess the incidence of IWS in the PICU at our center (academic children’s hospital). Secondary objective was to identify risk factors of IWS. Methods This is a descriptive and longitudinal retrospective study, including children admitted to our PICU between April 2015 and February 2017 who received opioids and/or benzodiazepines for more than 72 hours. The presence of IWS was assessed with the Withdrawal Assessment Tool-1 (WAT-1) or Neonatal Abstinence Score (NAS). Results 73 patients were included (median age of 8.7 weeks (4.4; 58.1)). The incidence of IWS in our population was 34.2% (25/73). Sedative/analgesic agents were used for an average of 160.8 hours (± 78.7). Main agents used were midazolam and morphine continuous infusions (68/73 (93.2%) and 49/73 (67.1%), respectively). Patients received a median of 0.52 mg/kg/day (0.35; 0.81) IV morphine equivalent and 0.36 mg/kg/day (0.25; 0.61) midazolam equivalent. IWS was more common in boys (OR: 4.4, 95% CI 1.4; 13.5), even after adjustment (OR: 5.4; 95% CI, 1.3–21.8). History of prematurity was also associated with increased risk of IWS (adjusted OR: 5.4; 95% CI, 1.1–26.6). There was no difference between the IWS and no-IWS groups for age, Pediatric Risk of Mortality (PRISM) score, total opioids and benzodiazepines doses and PICU length of stay. Conclusions IWS was seen in several patients admitted to PICU. This is more common among young boys and those with a history of prematurity.