{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T12:22:20Z","timestamp":1756902140699,"version":"3.44.0"},"reference-count":29,"publisher":"The Pediatric Pharmacy Association","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,10,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVE<\/jats:title>\n                  <jats:p>We estimated the effect of early initiation of dual therapy vs monotherapy on drug administration and related outcomes in mechanically ventilated, critically ill children.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>We used the electronic medical record at a single tertiary medical center to conduct an active comparator, new user cohort study. We included children &amp;lt;18 years of age who were exposed to a sedative or analgesic within 6 hours of intubation. We used stabilized inverse probability of treatment weighting to account for confounding at baseline. We estimated the average effect of initial dual therapy vs monotherapy on outcomes including cumulative opioid, benzodiazepine, and dexmedetomidine dosing; sedation scores; time to double the opioid or benzodiazepine infusion rate; initiation of neuromuscular blockade within the first 7 days of follow-up; time to extubation; and 7-day all-cause in-hospital death.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>The cohort included 640 patients. Children receiving dual therapy received 0.03 mg\/kg (95% CI, 0.02\u20130.04) more dexmedetomidine over the first 7 days after initiation of mechanical ventilation than did monotherapy patients. Dual therapy patients had similar sedation scores, time to double therapy, initiation of neuromuscular blockade, and time to extubation as monotherapy patients. Dual therapy patients had a lower incidence of death.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>In this study, initial dual therapy compared with monotherapy does not reduce overall drug administration during mechanical ventilation. The identified effect of dual therapy on mortality deserves further investigation.<\/jats:p>\n               <\/jats:sec>","DOI":"10.5863\/1551-6776-28.5.409","type":"journal-article","created":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T21:34:50Z","timestamp":1696368890000},"page":"409-416","source":"Crossref","is-referenced-by-count":0,"title":["Comparative Effectiveness of Dual- Versus Mono-Sedative Therapy on Opioid Administration, Sedative Administration, and Sedation Level in Mechanically Ventilated, Critically Ill Children"],"prefix":"10.5863","volume":"28","author":[{"given":"Kanecia O.","family":"Zimmerman","sequence":"first","affiliation":[{"name":"Duke Clinical Research Institute (KOZ, DKB), Duke University School of Medicine, Durham, NC"},{"name":"Department of Pediatrics (KOZ, DKB, DT), Duke University School of Medicine, Durham, NC"},{"name":"Department of Epidemiology (KOZ, DW, MJF, TS), Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Westreich","sequence":"additional","affiliation":[{"name":"Department of Epidemiology (KOZ, DW, MJF, TS), Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michele Jonsson","family":"Funk","sequence":"additional","affiliation":[{"name":"Department of Epidemiology (KOZ, DW, MJF, TS), Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"Jr.","given":"Daniel K.","family":"Benjamin","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute (KOZ, DKB), Duke University School of Medicine, Durham, NC"},{"name":"Department of Pediatrics (KOZ, DKB, DT), Duke University School of Medicine, Durham, NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Turner","sequence":"additional","affiliation":[{"name":"Department of Pediatrics (KOZ, DKB, DT), Duke University School of Medicine, Durham, NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Til","family":"St\u00fcrmer,","sequence":"additional","affiliation":[{"name":"Department of Epidemiology (KOZ, DW, MJF, TS), Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3883","published-online":{"date-parts":[[2023,10,3]]},"reference":[{"issue":"(1)","key":"2023111715284042100_i2331-348X-28-5-409-b1","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1186\/s12913-018-3041-x","article-title":"Pediatric admissions that include intensive care: a population-based study","volume":"18","author":"Ibiebele","year":"2018","journal-title":"BMC Health Serv 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