{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T17:18:56Z","timestamp":1767374336158,"version":"3.44.0"},"reference-count":11,"publisher":"The Pediatric Pharmacy Association","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021]]},"abstract":"<jats:sec>\n          <jats:title>OBJECTIVE<\/jats:title>\n          <jats:p>To determine the use of melatonin and its role in therapy for pediatric delirium (as either prophylaxis or treatment for delirium) in an academic medical center's PICU.<\/jats:p>\n        <\/jats:sec>\n        <jats:sec>\n          <jats:title>METHODS<\/jats:title>\n          <jats:p>This retrospective, single-center study reviewed patients between 1 and 18 years of age admitted to the PICU between April 1, 2014, and February 29, 2019. Patients were included if they were admitted for greater than 48 hours and received melatonin for the indication of \u201cdelirium.\u201d Patients were excluded if melatonin was a home medication. Data collected included baseline characteristics, sedation and antipsychotic usage, assessment scores, and admission overview data. Descriptive statistics were used to report categorical data as percentages.<\/jats:p>\n        <\/jats:sec>\n        <jats:sec>\n          <jats:title>RESULTS<\/jats:title>\n          <jats:p>A total of 63 patients were included. Thirty-nine patients (62%) required antipsychotics post\u2013melatonin exposure, with risperidone being the most frequently used agent. The average cumulative antipsychotic exposure pre\u2013 and post\u2013melatonin initiation was 2 versus 13 days. The average cumulative exposure to sedating agents, including opioids, benzodiazepines, ketamine, dexmedetomidine, and propofol, pre\u2013 and post\u2013melatonin initiation was 13 versus 10 days. The average hospital and PICU lengths of stay were 54 and 39 days, respectively. The initiation of melatonin was also associated with lighter levels of sedation and decreased pain scores.<\/jats:p>\n        <\/jats:sec>\n        <jats:sec>\n          <jats:title>CONCLUSION<\/jats:title>\n          <jats:p>Although the initiation of melatonin does not appear to decrease antipsychotic use, the results of this study may suggest a potential prophylactic effect in reducing the days of sedation the patient receives while inpatient.<\/jats:p>\n        <\/jats:sec>","DOI":"10.5863\/1551-6776-26.4.361","type":"journal-article","created":{"date-parts":[[2021,5,19]],"date-time":"2021-05-19T18:15:54Z","timestamp":1621448154000},"page":"361-365","source":"Crossref","is-referenced-by-count":1,"title":["Evaluation of Melatonin Practices for Delirium in Pediatric Critically Ill Patients"],"prefix":"10.5863","volume":"26","author":[{"given":"Thomas W.","family":"Laudone","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shawna D.","family":"Beck","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hubert J.","family":"Lahr","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3883","reference":[{"issue":"9","key":"i1551-6776-26-4-361-b1","series-title":"Curr Psychiatry Rep","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1007\/s11920-017-0817-3","article-title":"Pediatric delirium: evaluation, management, and special considerations","volume":"19","year":"2017","unstructured":"Malas\n              N,\n            \n            \n              Brahmbhatt\n              K,\n            \n            \n              McDermott\n              C,\n            \n          \n          .\n\t\t\t\t\tPediatric delirium: evaluation, management, and special considerations.\n\t\t\t\t\tCurr Psychiatry Rep.\n\t\t\t\t\t2017;\n\t\t\t\t\t19(\n\t\t\t\t\t9):\n\t\t\t\t\t65.\n\t\t\t\t\tdoi:10.1007\/s11920-017-0817-3"},{"issue":"5","key":"i1551-6776-26-4-361-b2","series-title":"Pediatr Clin North Am","first-page":"1117","article-title":"Delirium in pediatric critical care","volume":"64","year":"2017","unstructured":"Patel\n              AK,\n            \n            \n              Bell\n              MJ,\n            \n            \n              Traube\n              C.\n            \n          \n          Delirium in pediatric critical care.\n\t\t\t\t\tPediatr Clin North Am.\n\t\t\t\t\t2017;\n\t\t\t\t\t64(\n\t\t\t\t\t5):\n\t\t\t\t\t1117\u2013\n\t\t\t\t\t1132."},{"issue":"4","key":"i1551-6776-26-4-361-b3","series-title":"Crit Care Med","first-page":"584","article-title":"Pediatric delirium in critically-ill children: an international point prevalence study","volume":"45","year":"2017","unstructured":"Traube\n              C,\n            \n            \n              Silver\n              G,\n            \n            \n              Reeder\n              RW,\n            \n          \n          .\n\t\t\t\t\tPediatric delirium in critically-ill children: an international point prevalence study.\n\t\t\t\t\tCrit Care Med.\n\t\t\t\t\t2017;\n\t\t\t\t\t45(\n\t\t\t\t\t4):\n\t\t\t\t\t584\u2013\n\t\t\t\t\t590."},{"issue":"2","key":"i1551-6776-26-4-361-b4","series-title":"J Pediatr Pharmacol Ther","first-page":"81","article-title":"Antipsychotic use in the prevention and treatment of intensive care unit delirium in pediatric patients","volume":"25","year":"2020","unstructured":"Capino\n              AC,\n            \n            \n              Thomas\n              AN,\n            \n            \n              Baylor\n              S,\n            \n          \n          .\n\t\t\t\t\tAntipsychotic use in the prevention and treatment of intensive care unit delirium in pediatric patients.\n\t\t\t\t\tJ Pediatr Pharmacol Ther.\n\t\t\t\t\t2020;\n\t\t\t\t\t25(\n\t\t\t\t\t2):\n\t\t\t\t\t81\u2013\n\t\t\t\t\t95."},{"issue":"9","key":"i1551-6776-26-4-361-b5","series-title":"Crit Care Med","first-page":"e825","article-title":"Clinical practice guidelines for the prevention and management of pain, agitation\/sedation, delirium, immobility, and sleep disruption in adult patients in the ICU","volume":"46","year":"2018","unstructured":"Devlin\n              JW,\n            \n            \n              Skrobik\n              Y,\n            \n            \n              G\u00e9linas\n              C,\n            \n          \n          .\n\t\t\t\t\tClinical practice guidelines for the prevention and management of pain, agitation\/sedation, delirium, immobility, and sleep disruption in adult patients in the ICU.\n\t\t\t\t\tCrit Care Med.\n\t\t\t\t\t2018;\n\t\t\t\t\t46(\n\t\t\t\t\t9):\n\t\t\t\t\te825\u2013\n\t\t\t\t\te873."},{"issue":"4","key":"i1551-6776-26-4-361-b6","series-title":"Med Scim (Basel)","doi-asserted-by":"publisher","first-page":"90","DOI":"10.3390\/medsci6040090","article-title":"Sleep and delirium in pediatric critical illness: what is the relationship?","volume":"6","year":"2018","unstructured":"Calandriello\n              A,\n            \n            \n              Tylka\n              JC,\n            \n            \n              Patwari\n              PP.\n            \n          \n          Sleep and delirium in pediatric critical illness: what is the relationship?\n          \n            Med Scim (Basel)\n          .\n\t\t\t\t\t2018;\n\t\t\t\t\t6(\n\t\t\t\t\t4):\n\t\t\t\t\t90.\n\t\t\t\t\tdoi:10.3390\/medsci6040090"},{"issue":"1","key":"i1551-6776-26-4-361-b7","series-title":"Trials","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1186\/s13063-016-1751-0","article-title":"Prophylactic melatonin for delirium in intensive care (Pro-MEDIC): study protocol for a randomised controlled trial","volume":"18","year":"2017","unstructured":"Martinez\n              FE,\n            \n            \n              Anstey\n              M,\n            \n            \n              Ford\n              A,\n            \n          \n          .\n\t\t\t\t\tProphylactic melatonin for delirium in intensive care (Pro-MEDIC): study protocol for a randomised controlled trial.\n\t\t\t\t\tTrials.\n\t\t\t\t\t2017;\n\t\t\t\t\t18(\n\t\t\t\t\t1):\n\t\t\t\t\t4.\n\t\t\t\t\tdoi:10.1186\/s13063-016-1751-0"},{"series-title":"International Classification of Diseases, Tenth Revision (ICD-10)","key":"i1551-6776-26-4-361-b8","unstructured":"World Health Organization.\n          \n            International Classification of Diseases, Tenth Revision (ICD-10)\n          .\n\t\t\t\t\tWHO."},{"issue":"1","key":"i1551-6776-26-4-361-b9","series-title":"Syst Rev","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1186\/s13643-016-0378-2","article-title":"Melatonin and melatonin agonists to prevent and treat delirium in critical illness: a systematic review protocol","volume":"5","year":"2016","unstructured":"Foster\n              J,\n            \n            \n              Burry\n              LD,\n            \n            \n              Thabane\n              L,\n            \n          \n          .\n\t\t\t\t\tMelatonin and melatonin agonists to prevent and treat delirium in critical illness: a systematic review protocol.\n\t\t\t\t\tSyst Rev.\n\t\t\t\t\t2016;\n\t\t\t\t\t5(\n\t\t\t\t\t1):\n\t\t\t\t\t199.\n\t\t\t\t\tdoi:10.1186\/s13643-016-0378-2"},{"issue":"3","key":"i1551-6776-26-4-361-b10","series-title":"Pediatr Crit Care Med","first-page":"224","article-title":"Sleep monitoring in children during neuromuscular blockade in the pediatric intensive care unit: a pilot study","volume":"5","year":"2004","unstructured":"Carno\n              MA,\n            \n            \n              Hoffman\n              LA,\n            \n            \n              Henker\n              R,\n            \n          \n          .\n\t\t\t\t\tSleep monitoring in children during neuromuscular blockade in the pediatric intensive care unit: a pilot study.\n\t\t\t\t\tPediatr Crit Care Med.\n\t\t\t\t\t2004;\n\t\t\t\t\t5(\n\t\t\t\t\t3):\n\t\t\t\t\t224\u2013\n\t\t\t\t\t229."},{"issue":"2","key":"i1551-6776-26-4-361-b11","series-title":"J Pediatr","first-page":"357","article-title":"High endogenous melatonin levels in critically ill children: a pilot study","volume":"162","year":"2013","unstructured":"Marseglia\n              L,\n            \n            \n              Aversa\n              S,\n            \n            \n              Barberi\n              I,\n            \n          \n          .\n\t\t\t\t\tHigh endogenous melatonin levels in critically ill children: a pilot study.\n\t\t\t\t\tJ Pediatr.\n\t\t\t\t\t2013;\n\t\t\t\t\t162(\n\t\t\t\t\t2):\n\t\t\t\t\t357\u2013\n\t\t\t\t\t360."}],"container-title":["The Journal of Pediatric Pharmacology and Therapeutics"],"original-title":[],"link":[{"URL":"https:\/\/jppt.kglmeridian.com\/view\/journals\/jppt\/26\/4\/article-p361.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/meridian.allenpress.com\/jppt\/article-pdf\/26\/4\/361\/2830020\/i1551-6776-26-4-361.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/jppt.kglmeridian.com\/downloadpdf\/journals\/jppt\/26\/4\/article-p361.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/jppt.kglmeridian.com\/downloadpdf\/journals\/jppt\/26\/4\/article-p361.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,16]],"date-time":"2025-05-16T00:43:55Z","timestamp":1747356235000},"score":1,"resource":{"primary":{"URL":"https:\/\/jppt.kglmeridian.com\/view\/journals\/jppt\/26\/4\/article-p361.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021]]},"references-count":11,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.5863\/1551-6776-26.4.361","relation":{},"ISSN":["1551-6776"],"issn-type":[{"type":"print","value":"1551-6776"}],"subject":[],"published":{"date-parts":[[2021]]}}}