{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T17:37:08Z","timestamp":1774460228709,"version":"3.50.1"},"reference-count":30,"publisher":"Cambridge University Press (CUP)","issue":"6","license":[{"start":{"date-parts":[[2023,12,22]],"date-time":"2023-12-22T00:00:00Z","timestamp":1703203200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Cardiol Young"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S1047951123004262_as1\"><jats:title>Introduction:<\/jats:title><jats:p>Pain management is essential in the immediate post-surgical period. We sought to describe the ketorolac dose regimen in neonates and infants following cardiac surgery. Secondary outcomes included renal dysfunction, bleeding, and pain management.<\/jats:p><\/jats:sec><jats:sec id=\"S1047951123004262_as2\"><jats:title>Methods:<\/jats:title><jats:p>We performed a single-centre retrospective cohort study of neonates and infants (aged &lt; 12 months) who received ketorolac following cardiac surgery, from November 2020 through November 2021 (inclusive). Ketorolac was administered at 0.5 mg\/kg every 6 hours. Safety was defined by absence of a clinically significant decline in renal function (i.e., increase in serum creatinine [SCr] by \u2265 0.3 mg\/dL from baseline within 48 hours and\/or urine output \u2264 0.5 mL\/kg\/hour for 6 hours) and absence of clinically significant bleeding defined as major by International Society on Thrombosis and Hemostasis paediatric criteria or Severe\/Fatal Bleeding Events by Nellis et al. Efficacy measures included pain scores and opioid utilisation.<\/jats:p><\/jats:sec><jats:sec id=\"S1047951123004262_as3\"><jats:title>Results:<\/jats:title><jats:p>Fifty-five patients met eligibility criteria. The median (range) dose and duration of ketorolac administration was 0.5 mg\/kg\/dose for 48 (6\u201390) hours. Among all patients, there was not a statistically significant difference observed in median SCr within 48 hours of baseline (p &gt; .9). There were no major or severe bleeding events. The median (range) opioid requirements (morphine intravenous equivalents per kg per day) at 48 hours post-ketorolac initiation was 0.1 (0\u20130.8) mg\/kg\/day.<\/jats:p><\/jats:sec><jats:sec id=\"S1047951123004262_as4\"><jats:title>Conclusions:<\/jats:title><jats:p>If validated prospectively, these findings suggest that a ketorolac regimen 0.5 mg\/kg\/dose every 6 hours in neonates and infants post-cardiac surgery may be safe with regard to renal function and bleeding risk, and effective regarding opioid-sparing capacity.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s1047951123004262","type":"journal-article","created":{"date-parts":[[2023,12,22]],"date-time":"2023-12-22T04:20:04Z","timestamp":1703218804000},"page":"1199-1205","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":3,"title":["Ketorolac in neonates and infants following congenital heart surgery: a retrospective review"],"prefix":"10.1017","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1651-3620","authenticated-orcid":false,"given":"Amy L.","family":"Kiskaddon","sequence":"first","affiliation":[{"name":"Johns Hopkins All Children\u2019s Hospital"},{"name":"Johns Hopkins School of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arabela C.","family":"Stock","sequence":"additional","affiliation":[{"name":"Heart Institute, Johns Hopkins All Children\u2019s Hospital"},{"name":"Heart Institute, Johns Hopkins All Children\u2019s Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jamie L.","family":"Fierstein","sequence":"additional","affiliation":[{"name":"Institute for Clinical and Translational Research, Epidemiology and Biostatistics Shared Resource, Johns Hopkins All Children\u2019s Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandra","family":"Miller","sequence":"additional","affiliation":[{"name":"Institute for Clinical and Translational Research, Epidemiology and Biostatistics Shared Resource, Johns Hopkins All Children\u2019s Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James A.","family":"Quintessenza","sequence":"additional","affiliation":[{"name":"Heart Institute, Johns Hopkins All Children\u2019s Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neil","family":"Goldenberg","sequence":"additional","affiliation":[{"name":"Institute for Clinical and Translational Research, Epidemiology and Biostatistics Shared Resource, Johns Hopkins All Children\u2019s Hospital"},{"name":"Division of Hematology, Departments of Medicine and Pediatrics Johns Hopkins School of Medicine"},{"name":"Cancer and Blood Disorders Institute, Johns Hopkins All Children\u2019s Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2023,12,22]]},"reference":[{"key":"S1047951123004262_ref24","first-page":"347","article-title":"Evaluation of the safety of ketorolac in postsurgical infants less than six months of age","volume":"27","author":"McElroy","year":"2022","journal-title":"J Pediatr Pharmacol Ther"},{"key":"S1047951123004262_ref25","first-page":"1","article-title":"Kidney disease: improving global outcomes (KDIGO) acute kidney injury work group KDIGO clinical practice guidelines for acute kidney injury","volume":"2","author":"Khwaja","year":"2012","journal-title":"Kidney Int Suppl"},{"key":"S1047951123004262_ref5","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1097\/CCM.0000000000002771","article-title":"Intermittent versus continuous and intermittent medications for pain and sedation after pediatric cardiothoracic surgery; 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Published by Cambridge University Press","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}]}}