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87 Adverse Drug Events in a Pediatric Intensive Care Unit: A Prospective Survey
  1. DC Bourguignon da Silva1,2,
  2. OR Araujo3,
  3. RG Arduini3,
  4. CFR Alonso3,
  5. AR Ogawa Shibata4,
  6. EJ Troster4
  1. 1PICU, Universidade de São Paulo
  2. 2Oncologic PICU
  3. 3Universidade Federal de São Paulo
  4. 4Universidade de São Paulo, São Paulo, Brazil

Abstract

Background and aims Little is known about drugs pharmacokinetics and pharmodynamics in children. Renal and hepatic functions are not mature yet. Many drugs are used “off-label”. So, children are more susceptible to adverse drug events (ADE) than adults. As many drugs are used in pediatric intensive care units (PICU), we expect to find many ADE in this setting. Our aims are to describe ADE found in PICU and identify risk factors for their development.

Methods Six-month prospective cohort of all patients admitted to a single PICU. ADE were identified by active search and classified by Naranjo’s algorithm. Risk factors were identified by multivariate analysis.

Results 240 pediatric admissions occurred and 110 ADE were observed in 84 patients. Median age was 51 months. Only 39 of 240 patients didn’t have chronic status. Principal ADE were hyponatremia, hyperglycemia, hypokalemia. Drugs involved in most ADE were antibiotics, diuretics, antiepileptic, sedatives and analgesics and steroids. Age under 4 years, length of stay in PICU and number of drugs used are risk factors to ADE.

Conclusions There were 64.7 ADE/1000 patients-day in the present study. Hyponatremia, hypokalemia and hyperglycemia are the commonest ADE found. Age under 4, length of stay in PICU and number of drugs used are risk factors to ADE development.

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