咪唑安定在PICU的临床应用

The Clinical Application of Midazolam in PICU

目的:探讨咪唑安定在PICU镇静的适应症和效果。方法:对入住PICU年龄1月～1 0岁的危重患儿,静脉注射咪唑安定负荷量0 .1mg/kg作为镇静诱导,然后予维持量(1～5 ) μg/ (kg·min) ,用5 %葡萄糖或生理盐水稀释后持续静脉泵入。如果惊厥不能控制,则每5分钟增加维持量1 μg/ (kg·min) ,根据每个患儿临床需要达到的镇静程度,一般维持在清醒镇静程度到深度镇静。用药期间检测心率、呼吸、血压和经皮氧饱和度。每(2～4 )小时评价镇静程度。结果:共6 0例,男37例,女2 3例,机械通气1 0例。同时与其他镇静药物合用2 8例(46 .6 %) ,5 8例达到镇静(2～5 )级,有效率96 .6 7%,用药持续(1～5 )天,全部病例未发生任何副作用。机械通气病例镇静后氧合和通气明显改善,心率和经皮氧饱和度明显改善。结论:咪唑安定适用于PICU危重患儿的镇静,能提高机械通气的效率,控制患儿烦躁和焦虑状况,降低使病情恶化的因素。

Objective: To investigate the sedative effects of Midazolam on sedation of children in the pediatric intensive care unit (PICU). Methods: The cases (male 37,femal 23)aged 1 months～10 years in PICU were given firstly midazolam 0.1mg/kg for sedation by the intravenous injection then maintained the dose to (1～5)μg/(kg·min) via a vein pump (5% glucose or normal saline + midazolam). The dose could increase every 5 minutes 1μg/(kg·min)if disable control the convulsion. At the time of administration, the heart rate, respiration rate, blood pressure and the degree of oxygen saturation would be examined and the sedative degree was evaluated each (2～4) hours. Results: The sedative degree of 58 cases obtained to reach 2～5 grade( 96.67%) and the therapy was kelp for (1～5) days. The SaO 2 and ventilation were improved significantly in 10 cases with mechanical ventilation. There was no any bad effect to incidence. Conclusions: The Midazolam can be better for use to reach the aim of the sedation for the children in the PICU and can increase the efficiency of the mechanical ventilation.