{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T12:22:29Z","timestamp":1756902149112,"version":"3.44.0"},"reference-count":24,"publisher":"The Pediatric Pharmacy Association","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024]]},"abstract":"<jats:sec>\n          <jats:title>OBJECTIVE<\/jats:title>\n          <jats:p>Difficult analgosedation is common and challenging in the pediatric intensive care unit (PICU). It is important to study alternative and supplemental sedatives for when the first-line agents become \u00adinsufficient.<\/jats:p>\n        <\/jats:sec>\n        <jats:sec>\n          <jats:title>METHODS<\/jats:title>\n          <jats:p>In this retrospective chart-review study, we report our center\u2019s experience in using intermittent doses of enteral pentobarbital as an adjunct sedative in 13 difficult to sedate critically ill and mechanically ventilated children. We compare the average sedation score and cumulative doses of other \u00adsedatives (opioids, benzodiazepines and alpha-2 agonists) in the 24 hours before and 24 hours after enteral \u00adpentobarbital initiation.<\/jats:p>\n        <\/jats:sec>\n        <jats:sec>\n          <jats:title>RESULTS<\/jats:title>\n          <jats:p>The addition of enteral pentobarbital was associated with lower State Behavioral State (SBS) scores in 8 out of the 13 patients and on average smaller doses of opioids (decreased by 11%), \u00adbenzodiazepines (BZD) (decreased by 5%) and alpha-agonists (decreased by 20%). No adverse effects were noted attributable to pentobarbital administration.<\/jats:p>\n        <\/jats:sec>\n        <jats:sec>\n          <jats:title>CONCLUSION<\/jats:title>\n          <jats:p>Enteral pentobarbital seems to be safe and effective agent in the difficult to sedate critically ill child.<\/jats:p>\n        <\/jats:sec>","DOI":"10.5863\/1551-6776-29.1.32","type":"journal-article","created":{"date-parts":[[2024,2,12]],"date-time":"2024-02-12T12:01:47Z","timestamp":1707739307000},"page":"32-36","source":"Crossref","is-referenced-by-count":0,"title":["Enteral Pentobarbital in the Difficult to Sedate Critically Ill Children"],"prefix":"10.5863","volume":"29","author":[{"given":"Salim","family":"Aljabari","sequence":"first","affiliation":[{"name":"Department of Pediatrics (SA), University of Arkansas for Medical Sciences\/Arkansas Children\u2019s Hospital, Little Rock, AR;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shannon","family":"Keaveney","sequence":"additional","affiliation":[{"name":"School of Medicine (SK), University of Missouri, Columbia, MO;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jordan","family":"Anderson","sequence":"additional","affiliation":[{"name":"School of Pharmacy (JA), University of Missouri, Columbia, MO"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3883","reference":[{"issue":"1","key":"i2331-348X-29-1-32-b01","series-title":"J Anesth Analg Crit Care","first-page":"9","article-title":"Recommendations for analgesia and sedation in critically ill children admitted to intensive care unit","volume":"2","author":"Amigoni","year":"2022","unstructured":"Amigoni\n              A\n            , ContiG, ConioA, \n          . Recommendations for analgesia and sedation in critically ill children admitted to intensive care unit. J Anesth Analg Crit Care. 2022;2(1):9."},{"issue":"3","key":"i2331-348X-29-1-32-b02","series-title":"Aust Crit Care","first-page":"167","article-title":"Face and content validity of variables associated with the difficult-to-sedate child in the paediatric intensive care unit: A survey of paediatric critical care clinicians","volume":"31","author":"Lebet","year":"2018","unstructured":"Lebet\n              RM\n            , AsaroLA, ZuppaAF, CurleyMAQ. Face and content validity of variables associated with the difficult-to-sedate child in the paediatric intensive care unit: A survey of paediatric critical care clinicians. Aust Crit Care. 2018May;31(3):167\u2013173."},{"issue":"2","key":"i2331-348X-29-1-32-b03","series-title":"Pediatr Crit Care Med","first-page":"e74","article-title":"Society of Critical Care Medicine Clinical Practice Guidelines on Prevention and Management of Pain, Agitation, Neuromuscular Blockade, and Delirium in Critically Ill Pediatric Patients With Consideration of the ICU Environment and Early Mobility","volume":"23","author":"Smith","year":"2022","unstructured":"Smith\n              HAB\n            , BesunderJB, BettersKA, \n          . 2022Society of Critical Care Medicine Clinical Practice Guidelines on Prevention and Management of Pain, Agitation, Neuromuscular Blockade, and Delirium in Critically Ill Pediatric Patients With Consideration of the ICU Environment and Early Mobility. Pediatr Crit Care Med. 2022;23(2):e74\u2013e110."},{"issue":"8","key":"i2331-348X-29-1-32-b04","series-title":"Intensive Care Med","first-page":"1125","article-title":"Consensus guidelines on sedation and analgesia in critically ill children","volume":"32","author":"Playfor","year":"2006","unstructured":"Playfor\n              S\n            , JenkinsI, BoylesC, \n          . Consensus guidelines on sedation and analgesia in critically ill children. Intensive Care Med. 2006;32(8):1125\u20131136."},{"issue":"9","key":"i2331-348X-29-1-32-b05","series-title":"J Clin Med","first-page":"1847","article-title":"Current state of analgesia and sedation in the pediatric intensive care unit","volume":"10","author":"Egbuta","year":"2021","unstructured":"Egbuta\n              C\n            , MasonKP. Current state of analgesia and sedation in the pediatric intensive care unit. J Clin Med. 2021;10(9):1847."},{"issue":"3","key":"i2331-348X-29-1-32-b06","series-title":"Crit Care","first-page":"R103","article-title":"Is pentobarbital safe and efficacious in the treatment of super-refractory status epilepticus: a cohort study","volume":"18","author":"Pugin","year":"2014","unstructured":"Pugin\n              D\n            , ForemanB, De MarchisG, \n          . Is pentobarbital safe and efficacious in the treatment of super-refractory status epilepticus: a cohort study. Crit Care. 2014;18(3):R103."},{"issue":"4","key":"i2331-348X-29-1-32-b07","series-title":"Echocardiography","first-page":"766","article-title":"Comparison of chloral hydrate and pentobarbital sedation for pediatric echocardiography","volume":"36","author":"Ganigara","year":"2019","unstructured":"Ganigara\n              M\n            , SrivastavaS, MalikP, \n          . Comparison of chloral hydrate and pentobarbital sedation for pediatric echocardiography. Echocardiography. 2019;36(4):766\u2013769."},{"issue":"6","key":"i2331-348X-29-1-32-b08","series-title":"J Pediatr Pharmacol Ther","first-page":"460","article-title":"Is orally administered pentobarbital a safe and effective alternative to chloral hydrate for pediatric procedural sedation?","volume":"23","author":"Anderson","year":"2018","unstructured":"Anderson\n              J\n            , DalabihS, BirisiE, DalabihA. Is orally administered pentobarbital a safe and effective alternative to chloral hydrate for pediatric procedural sedation?J Pediatr Pharmacol Ther. 2018;23(6):460\u2013465."},{"issue":"1","key":"i2331-348X-29-1-32-b09","series-title":"J Am Soc Echocardiogr","first-page":"33","article-title":"The efficacy and safety of oral pentobarbital sedation in pediatric echocardiography","volume":"23","author":"Warden","year":"2010","unstructured":"Warden\n              CN\n            , BernardPK, KimballTR. The efficacy and safety of oral pentobarbital sedation in pediatric echocardiography. J Am Soc Echocardiogr. 2010;23(1):33\u201337. doi:10.1016\/j.echo.2009.09.021"},{"issue":"12","key":"i2331-348X-29-1-32-b10","series-title":"Acad Emerg Med","first-page":"1370","article-title":"Comparison of intravenous midazolam with pentobarbital for sedation for head computed tomography imaging","volume":"7","author":"Moro-Sutherland","year":"2000","unstructured":"Moro-Sutherland\n              DM\n            , AlgrenJT, LouisPT, \n          . Comparison of intravenous midazolam with pentobarbital for sedation for head computed tomography imaging. 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Comparison of intranasal dexmedetomidine and oral pentobarbital sedation for transthoracic echocardiography in infants and toddlers: a prospective, randomized, double-blind trial. Anesth Analg. 2018;126(6):2009\u20132016."},{"issue":"6","key":"i2331-348X-29-1-32-b13","series-title":"Pediatr Anesth","first-page":"601","article-title":"Propofol vs pentobarbital for sedation of children undergoing magnetic resonance imaging: results from the Pediatric Sedation Research Consortium: propofol vs pentobarbital for MRI sedation","volume":"19","author":"Mallory","year":"2009","unstructured":"Mallory\n              MD\n            , BaxterAL, KostSI; The Pediatric Sedation Research Consortium. Propofol vs pentobarbital for sedation of children undergoing magnetic resonance imaging: results from the Pediatric Sedation Research Consortium: propofol vs pentobarbital for MRI sedation. 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Cornell Assessment of Pediatric Delirium: a valid, rapid, observational tool for screening delirium in the PICU. Crit Care Med. 2014;42(3):656\u2013663."},{"issue":"No. RR-1","key":"i2331-348X-29-1-32-b16","series-title":"MMWR Recomm Rep","first-page":"1","article-title":"CDC guidelines for prescribing opioids for chronic pain - United States, 2016","volume":"65","author":"Dowell","year":"2016","unstructured":"Dowell\n              D\n            , HaegerichTM, ChouR. CDC guidelines for prescribing opioids for chronic pain - United States, 2016. MMWR Recomm Rep. 2016;65(No. RR-1):1\u201349."},{"key":"i2331-348X-29-1-32-b17","article-title":"Equianalgesic Dosing of Opioids for Pain Management. Pharmacist\u2019s Letter\/Prescriber\u2019s Letter","author":"PL Detail-Document","year":"2015","unstructured":"PL Detail-Document\n          , Equianalgesic Dosing of Opioids for Pain Management. Pharmacist\u2019s Letter\/Prescriber\u2019s Letter. July2015. 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Pentobarbital for Sedation during Mechanical Ventilation in the Pediatric ICU Patient. J Intensive Care Med. 2000;15(2)."},{"issue":"3","key":"i2331-348X-29-1-32-b20","series-title":"J Crit Care","first-page":"174","article-title":"Continuous pentobarbital infusion in children is associated with high rates of complications","volume":"19","author":"Yanay","year":"2004","unstructured":"Yanay\n              O\n            , BroganTV, MartinLD. Continuous pentobarbital infusion in children is associated with high rates of complications. J Crit Care. 2004;19(3):174\u2013178."},{"issue":"5","key":"i2331-348X-29-1-32-b21","series-title":"Pediatr Clin North Am","first-page":"1117","article-title":"Delirium in pediatric critical care","volume":"64","author":"Patel","year":"2017","unstructured":"Patel\n              AK\n            , BellMJ, TraubeC. Delirium in pediatric critical care. 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Am J Roentgenol. 2011;196(2):W194\u2013W198."},{"issue":"1","key":"i2331-348X-29-1-32-b24","series-title":"Crit Care","first-page":"3","article-title":"Enteral versus intravenous approach for the sedation of critically ill patients: a randomized and controlled trial","volume":"23","author":"Mistraletti","year":"2019","unstructured":"Mistraletti\n              G\n            , UmbrelloM, ; The SedaEN Investigators. Enteral versus intravenous approach for the sedation of critically ill patients: a randomized and controlled trial. Crit Care. 2019;23(1):3."}],"container-title":["The Journal of Pediatric Pharmacology and Therapeutics"],"original-title":[],"link":[{"URL":"https:\/\/jppt.kglmeridian.com\/view\/journals\/jppt\/29\/1\/article-p32.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/meridian.allenpress.com\/jppt\/article-pdf\/29\/1\/32\/3325941\/i2331-348x-29-1-32.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/jppt.kglmeridian.com\/downloadpdf\/journals\/jppt\/29\/1\/article-p32.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/jppt.kglmeridian.com\/downloadpdf\/journals\/jppt\/29\/1\/article-p32.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,16]],"date-time":"2025-05-16T00:52:12Z","timestamp":1747356732000},"score":1,"resource":{"primary":{"URL":"https:\/\/jppt.kglmeridian.com\/view\/journals\/jppt\/29\/1\/article-p32.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024]]},"references-count":24,"journal-issue":{"issue":"1"},"URL":"https:\/\/doi.org\/10.5863\/1551-6776-29.1.32","relation":{},"ISSN":["2331-348X","1551-6776"],"issn-type":[{"type":"electronic","value":"2331-348X"},{"type":"print","value":"1551-6776"}],"subject":[],"published":{"date-parts":[[2024]]}}}