P0046 / #639: THE IMPACT OF BENZODIAZEPINES AND OPIOIDS ON NEUROCOGNITIVE DEVELOPMENT IN CHILDREN

Abstract

Aims & Objectives: General anesthetics and sedatives are widely used for critically ill children admitted to the Pediatric Intensive Care Unit (PICU). Animal studies have indicated that exposure of the immature brain to these agents may cause neurodegeneration. In human adults, studies have shown an inverse association between cumulative doses of benzodiazepines and neurocognitive functioning. Literature on this association in children is scarce. This study aims to explore the impact of benzodiazepines and opioids on neurocognitive development in children. Methods: Children aged 6-12 years admitted to our PICU (age ≤10 months) for respiratory insufficiency due to severe viral lower respiratory tract infections were included. All children required mechanical ventilation for which they also received midazolam and morphine. Healthy peers, matched with patients on age, sex and socio-economic status, acted as controls. We assessed full-scale IQ (FSIQ) and computerized tests of attention, learning and memory, executive functioning and sensory and motor functioning. Results: Included were 41 patients (24 males) and 41 controls (17 males). Mean (SD) age of patients and controls was 8.6 (0.8) and 8.9 (1.0) years, respectively. Preliminary results indicate that, compared to healthy peers, children in the exposure group have a significantly lower FSIQ (d=-0.56, p = 0.02); and a significantly poorer verbal memory, including both short (d=-0.47, p = 0.04) and long-term memory (d=-0.50, p = 0.03). Other results await analyses. Conclusions: Preliminary results suggest that children with a history of mechanical ventilation and exposure to midazolam and morphine are at risk of decreased neurocognitive functioning.