Article Text
Abstract
Introduction We sought to detect a relationship between midazolam concentration and development of new delirium in critically ill children who were on continuous midazolam administration.
Methods Delirium was detected using the Sophia Observation withdrawal Symptoms - Paediatric Delirium (SOS-PD) score and 104 left-over samples were available to measure midazolam concentrations.
Results Twenty-five percent of the included patients developed new delirium. Median cumulative midazolam dose was higher in patients who developed delirium compared to those without delirium but lower compared with the day preceding delirium detection, indicative of a rapid decline. Similar findings were made when active metabolites 1-hydroxymidazolam and 1-hydroxymidazolam glucuronide were considered.
Conclusions A sudden and significant reduction in midazolam concentration may contribute to the development of a delirium in critically ill children.