{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T15:44:33Z","timestamp":1786376673587,"version":"build-2736575974"},"reference-count":20,"publisher":"The Pediatric Pharmacy Association","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023]]},"abstract":"<jats:sec>\n          <jats:title>OBJECTIVES<\/jats:title>\n          <jats:p>Sleep deprivation is a risk factor for delirium development, which is a frequent complication of intensive care unit admission. Melatonin has been used for both delirium prevention and treatment. Melatonin safety, efficacy, and dosing information in neonates and infants is lacking. The purpose of this study was to describe melatonin use in infants regarding indication, dosing, efficacy, and safety.<\/jats:p>\n        <\/jats:sec>\n        <jats:sec>\n          <jats:title>METHODS<\/jats:title>\n          <jats:p>This descriptive, retrospective study included infants &lt;12 months of age admitted to an intensive care unit receiving melatonin. Data collection included demographics, melatonin regimen, sedative and analgesic agents, antipsychotics, and delirium-causing medications. The primary objective was to identify the melatonin indication and median dose. The secondary objectives included change in delirium, pain, and sedation scores; change in dosing of analgesic and sedative agents; and adverse event identification. Wilcoxon signed rank tests and linear mixed models were employed with significance defined at p &lt; 0.05.<\/jats:p>\n        <\/jats:sec>\n        <jats:sec>\n          <jats:title>RESULTS<\/jats:title>\n          <jats:p>Fifty-five patients were included, with a median age of 5.5 months (IQR, 3.9\u20138.2). Most (n = 29; 52.7%) received melatonin for sleep promotion. The median body weight\u2013based dose was 0.31 mg\/kg\/dose (IQR, 0.20\u20130.45). There was a statistical reduction in cumulative morphine equivalent dosing 72 hours after melatonin administration versus before, 17.1 versus 21.4 mg\/kg (p = 0.049). No adverse events were noted.<\/jats:p>\n        <\/jats:sec>\n        <jats:sec>\n          <jats:title>CONCLUSIONS<\/jats:title>\n          <jats:p>Most patients (n = 29; 52.7%) received melatonin for sleep promotion at a median dose was 0.31 mg\/kg\/dose. Initiation of melatonin was associated with a reduction of opioid exposure; however, there was no reduction in pain\/sedation scores.<\/jats:p>\n        <\/jats:sec>","DOI":"10.5863\/1551-6776-28.7.635","type":"journal-article","created":{"date-parts":[[2023,11,28]],"date-time":"2023-11-28T08:58:46Z","timestamp":1701161926000},"page":"635-642","source":"Crossref","is-referenced-by-count":4,"title":["Melatonin Use in Infants Admitted to Intensive Care Units"],"prefix":"10.5863","volume":"28","author":[{"given":"Caitlyn","family":"Bradford","sequence":"first","affiliation":[{"name":"Department of Pharmacy Practice (CB), Philadelphia College of Pharmacy, Saint Joseph\u2019s University, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamie L.","family":"Miller","sequence":"additional","affiliation":[{"name":"Department of Pharmacy: Clinical and Administrative Sciences (JLM, SBN, PNJ), College of Pharmacy, University of Oklahoma Health Sciences Center, Oklahoma City, OK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maura","family":"Harkin","sequence":"additional","affiliation":[{"name":"Department of Pharmacy (MH), Oklahoma Children\u2019s Hospital at OU Health, Oklahoma City, OK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hala","family":"Chaaban","sequence":"additional","affiliation":[{"name":"Department of Pediatrics (HC), College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen B.","family":"Neely","sequence":"additional","affiliation":[{"name":"Department of Pharmacy: Clinical and Administrative Sciences (JLM, SBN, PNJ), College of Pharmacy, University of Oklahoma Health Sciences Center, Oklahoma City, OK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter N.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Department of Pharmacy: Clinical and Administrative Sciences (JLM, SBN, PNJ), College of Pharmacy, University of Oklahoma Health Sciences Center, Oklahoma City, OK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3883","reference":[{"issue":"(7)","key":"i2331-348X-28-7-635-b1","series-title":"Pharmacotherapy","first-page":"692","article-title":"Melatonin use in hospitalized children for non-anesthetic indications: a systemic review","volume":"40","author":"Procaccini","year":"2020","unstructured":"Procaccini\n              DE\n            , LobnerK, AntonB,\n          . Melatonin use in hospitalized children for non-anesthetic indications: a systemic review. Pharmacotherapy. 2020;40(7):692\u2013703."},{"issue":"(9)","key":"i2331-348X-28-7-635-b2","series-title":"JAMA Pediatr","first-page":"883","article-title":"Association of sleep problems and melatonin use in school-aged children","volume":"173","author":"Koopman-Verhoeff","year":"2019","unstructured":"Koopman-Verhoeff\n              MEA\n            , van den DriesM, van SetersJJ,\n          . Association of sleep problems and melatonin use in school-aged children. JAMA Pediatr. 2019;173(9):883\u2013885."},{"key":"i2331-348X-28-7-635-b3","series-title":"Hosp Pediatr","first-page":"e308\u2013311","article-title":"Melatonin administration patterns for pediatric inpatients in a tertiary children\u2019s hospital","volume":"11","author":"Procaccini","year":"2021","unstructured":"Procaccini\n              DE\n            , KudchadkarSR. Melatonin administration patterns for pediatric inpatients in a tertiary children\u2019s hospital. Hosp Pediatr. 2021;11:e308\u2013311."},{"issue":"(7)","key":"i2331-348X-28-7-635-b4","series-title":"J Intensive Care Med","first-page":"451","article-title":"Emerging role of melatonin and melatonin receptor agonists in sleep and delirium in intensive care unit patients","volume":"31","author":"Mo","year":"2016","unstructured":"Mo\n              Y\n            , ScheerCE, AbdallahGT. Emerging role of melatonin and melatonin receptor agonists in sleep and delirium in intensive care unit patients. J Intensive Care Med. 2016;31(7):451\u2013455."},{"issue":"(2)","key":"i2331-348X-28-7-635-b5","series-title":"Ped Crit Care Med","first-page":"e74","article-title":"PANDEM guidelines for infants and children","volume":"23","author":"Smith","year":"2022","unstructured":"Smith\n              HAB\n            , BerkenboschJW, BettersKA,\n          . PANDEM guidelines for infants and children. Ped Crit Care Med. 2022;23(2):e74\u2013e110."},{"issue":"(4)","key":"i2331-348X-28-7-635-b6","series-title":"J Pediatr Pharmacol Ther","first-page":"361","article-title":"Evaluation of melatonin practices for delirium in pediatric critically ill patients","volume":"26","author":"Laudone","year":"2021","unstructured":"Laudone\n              TW\n            , BeckSD, LahrHJ. Evaluation of melatonin practices for delirium in pediatric critically ill patients. J Pediatr Pharmacol Ther. 2021;26(4):361\u2013365."},{"issue":"(9)","key":"i2331-348X-28-7-635-b7","series-title":"Intensive Care Med","first-page":"943","article-title":"Pharmacological and non-pharmacological interventions to prevent delirium in critically ill patients: a systematic review and network meta-analysis","volume":"47","author":"Burry","year":"2021","unstructured":"Burry\n              LD\n            , ChengW, WilliamsonDR,\n          . 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Pediatric Pharmacotherapy. 2nd ed. Lenexa, KS: American College of Clinical Pharmacy; 2020: 900\u2013943."},{"issue":"(10)","key":"i2331-348X-28-7-635-b10","series-title":"Am J Psychiatry","first-page":"1172","article-title":"Infant delirium in pediatric critical care settings","volume":"167","author":"Silver","year":"2010","unstructured":"Silver\n              GH\n            , KearneyJA, KutkoMC, BartellAS. Infant delirium in pediatric critical care settings. Am J Psychiatry. 2010;167(10):1172\u20131177."},{"issue":"(1)","key":"i2331-348X-28-7-635-b11","series-title":"Arch Dis Child Fetal Neonatal","first-page":"F36","article-title":"Development and initial validation of the EDIN scale, a new tool for assessing prolonged pain in preterm infants","volume":"85","author":"Debillon","year":"2001","unstructured":"Debillon\n              T\n            , ZupanV, RavaultN,\n          . Development and initial validation of the EDIN scale, a new tool for assessing prolonged pain in preterm infants. Arch Dis Child Fetal Neonatal. 2001;85(1):F36\u2013F41."},{"key":"i2331-348X-28-7-635-b12","series-title":"SAS for Mixed Models","author":"Littell","year":"2006","unstructured":"Littell\n              RC\n            , MillikenGA, StroupWW,\n          . SAS for Mixed Models. 2nd ed. Cary, NC: SAS Institute Inc; 2006."},{"issue":"(2)","key":"i2331-348X-28-7-635-b13","series-title":"Eur J Paediatr Neurol","first-page":"122","article-title":"Current role of melatonin in pediatric neurology: clinical recommendations","volume":"19","author":"Bruni","year":"2015","unstructured":"Bruni\n              O\n            , Alonso-AlconadaD, BesagF,\n          . Current role of melatonin in pediatric neurology: clinical recommendations. Eur J Paediatr Neurol. 2015;19(2):122\u2013133."},{"issue":"(3)","key":"i2331-348X-28-7-635-b14","series-title":"Psychopharmacology (Berl)","first-page":"379","article-title":"Dose finding of melatonin for chronic idiopathic childhood sleep onset insomnia: an RCT","volume":"212","author":"Van Geijlswijk","year":"2010","unstructured":"Van Geijlswijk\n              IM\n            , van der HerijdenKB, EgbertsACG,\n          . Dose finding of melatonin for chronic idiopathic childhood sleep onset insomnia: an RCT. Psychopharmacology (Berl). 2010;212(3):379\u2013391."},{"issue":"(2)","key":"i2331-348X-28-7-635-b15","series-title":"Neonatal Netw","first-page":"103","article-title":"Delirium in the NICU: risk or reality?","volume":"40","author":"Liviskie","year":"2021","unstructured":"Liviskie\n              C\n            , McPhersonC. Delirium in the NICU: risk or reality?Neonatal Netw. 2021;40(2):103\u2013112."},{"issue":"(22)","key":"i2331-348X-28-7-635-b16","series-title":"MMWR Morb Mortal Wkly Rep","first-page":"725","article-title":"Pediatric melatonin ingestions\u2013United States 2012-2021","volume":"71","author":"Lelak","year":"2022","unstructured":"Lelak\n              K\n            , VohraV, NeumanMI,\n          . Pediatric melatonin ingestions\u2013United States 2012-2021. MMWR Morb Mortal Wkly Rep. 2022;71(22):725\u2013729."},{"issue":"(10)","key":"i2331-348X-28-7-635-b17","series-title":"J Clin Endocrinol Metab","first-page":"4727","article-title":"Melatonin treatment for age-related insomnia","volume":"86","author":"Zhdanova","year":"2001","unstructured":"Zhdanova\n              IV\n            , WurtmanRJ, ReganMM,\n          . Melatonin treatment for age-related insomnia. 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Preventing brain injury in the preterm infant\u2013current controversies and potential therapies. Int J Mol Sci. 2021;22(4):1671."},{"issue":"(2)","key":"i2331-348X-28-7-635-b20","series-title":"J Clin Sleep Med","first-page":"275","article-title":"Melatonin natural health products and supplements: presence of serotonin and significant variability of melatonin content","volume":"13","author":"Erland","year":"2017","unstructured":"Erland\n              LA\n            , SaxenaPK. Melatonin natural health products and supplements: presence of serotonin and significant variability of melatonin content. J Clin Sleep Med. 2017;13(2):275\u2013281."}],"container-title":["The Journal of Pediatric Pharmacology and Therapeutics"],"original-title":[],"link":[{"URL":"https:\/\/jppt.kglmeridian.com\/view\/journals\/jppt\/28\/7\/article-p635.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/meridian.allenpress.com\/jppt\/article-pdf\/28\/7\/635\/3293048\/i2331-348x-28-7-635.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/jppt.kglmeridian.com\/downloadpdf\/journals\/jppt\/28\/7\/article-p635.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/jppt.kglmeridian.com\/downloadpdf\/journals\/jppt\/28\/7\/article-p635.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,16]],"date-time":"2025-05-16T00:48:45Z","timestamp":1747356525000},"score":1,"resource":{"primary":{"URL":"https:\/\/jppt.kglmeridian.com\/view\/journals\/jppt\/28\/7\/article-p635.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023]]},"references-count":20,"journal-issue":{"issue":"7"},"URL":"https:\/\/doi.org\/10.5863\/1551-6776-28.7.635","relation":{},"ISSN":["2331-348X","1551-6776"],"issn-type":[{"value":"2331-348X","type":"electronic"},{"value":"1551-6776","type":"print"}],"subject":[],"published":{"date-parts":[[2023]]}}}