{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T16:07:17Z","timestamp":1781194037229,"version":"3.54.1"},"reference-count":32,"publisher":"Georg Thieme Verlag KG","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:p>\n            Objective\u2003The study aims to describe our experience with the implementation of phenobarbital as a primary sedation strategy during neonatal extracorporeal membrane oxygenation (ECMO).<\/jats:p><jats:p>\n            Study Design\u2003Retrospective chart review in a level IV neonatal intensive care unit between 2011 and 2021 comparing neonatal ECMO patients before and after the implementation of a sedation-analgesia (SA) protocol using scheduled phenobarbital as the primary sedative. Groups were compared for neonatal and ECMO characteristics, cumulative SA doses, and in-hospital outcomes. Comparison between groups was performed using Mann\u2013Whitney test on continuous variables and chi-square on nominal variables.<\/jats:p><jats:p>\n            Results\u2003Forty-two patients were included, 23 preprotocol and 19 postprotocol. Birth, pre-ECMO, and ECMO clinical characteristics were similar between groups except for a lower birth weight in the postprotocol group (p\u2009=\u20090.024). After standardization of phenobarbital SA protocol, there was a statistically significant reduction in median total morphine dose (31.38\u201317.65\u2009mg\/kg, p\u2009=\u20090.006) and median total midazolam dose (36.21\u20136.36\u2009mg\/kg, p\u2009&lt;\u20090.001). There was also a reduction in median total days on morphine by 7.5 days (p\u2009=\u20090.026) and midazolam by 6.6 days (p\u2009=\u20090.003). There were no differences in ECMO duration or in-hospital outcomes between groups.<\/jats:p><jats:p>\n            Conclusion\u2003In this cohort, short-term use of phenobarbital as primary sedation strategy during neonatal ECMO was associated with reduced opioid and midazolam burden. Such reduction, however, did not affect in-hospital outcomes.<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/s-0044-1779255","type":"journal-article","created":{"date-parts":[[2024,2,17]],"date-time":"2024-02-17T00:26:12Z","timestamp":1708129572000},"page":"1586-1591","source":"Crossref","is-referenced-by-count":2,"title":["Phenobarbital as a Sedation Strategy to Reduce Opioid and Benzodiazepine Burden in Neonatal Extracorporeal Membrane Oxygenation"],"prefix":"10.1055","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5384-2429","authenticated-orcid":false,"given":"Vilmaris Quinones","family":"Cardona","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics, St. Christopher's Hospital for Children, Philadelphia, Pennsylvania"},{"name":"Department of Pediatrics, Drexel University College of Medicine, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9740-6899","authenticated-orcid":false,"given":"Emma","family":"Byrne","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Drexel University College of Medicine, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Mejia","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics, St. Christopher's Hospital for Children, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Swosti","family":"Joshi","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics, St. Christopher's Hospital for Children, Philadelphia, Pennsylvania"},{"name":"Department of Pediatrics, Drexel University College of Medicine, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ogechukwu","family":"Menkiti","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics, St. Christopher's Hospital for Children, Philadelphia, Pennsylvania"},{"name":"Department of Pediatrics, Drexel University College of Medicine, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2024,2,16]]},"reference":[{"issue":"02","key":"ref1","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1053\/j.semperi.2017.12.002","article-title":"An overview of medical ECMO for neonates","volume":"42","author":"K Fletcher","year":"2018","journal-title":"Semin Perinatol"},{"issue":"05","key":"ref2","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1097\/MAT.0000000000001043","article-title":"Sedation practices of neonates receiving extracorporeal membrane oxygenation","volume":"66","author":"C 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