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PHARMACOTHERAPY IN NEONATES AFTER PERINATAL ASPHYXIA (NICU EXPERIENCE)
  1. P Pokorna1,
  2. V Vobruba1,
  3. M Sadlo1,
  4. O Cerna1,
  5. V Kredba1,
  6. P Srnsky1,
  7. P Klement1,
  8. O Slanar2,
  9. F Perlik2
  1. 1Department of Pediatrics, General Faculty Hospital Prague, Prague, Czech Republic
  2. 2Department of Pharmacology, General Faculty Hospital Prague, Prague, Czech Republic

Abstract

Objective The aim of our estimation was to study a part of pharmacotherapy in neonates after perinatal asphyxia.

Methods 22 term neonates with diagnosed hypoxic-ischaemic encephalopathy (HIE) have been studied at NICU. Symptoms of HIE were described: hypotonia (100%), coma (63,6%), seizures (27,3%) and aEEG-30 minutes estimation before, during and after coolling period has been indicated (subclinical seizures in 13,6% of all neonates).

Results Studied drugs applicated to neonates at first week of postnatal age were: midazolam (45,4%), sufentanyl (72,7%), tramadol (31,8%), morphin (13,6%), phenobarbital (100% at acute phase resp. 22,7% at late phase), phenytoin (18,2%), diazepam (4,5%). Drug concentrations were measured in the group of neonates with phenobarbital (n = 10) and in the group with phenytoin (n = 4) until 48 hours after an initial dose of drugs. Drug concentrations were without therapeutical ranges in group of neonates with combination of drugs. Dosage of phenobarbital/phenytoin was reduced.

Conclusions Therapeutical drug monitoring in neonates after perinatal asphyxia will be the optimal way of pharmacotherapy in this group of neonates. Individual dosage of drugs and more experience are needed. (Project IgA 8632-5, Czech Republic)

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