Hartwig S, Roth B, Theisohn M
Children's Hospital University of Cologne, Federal Republic of Germany.
Eur J Pediatr. 1991 Sep;150(11):784-8. doi: 10.1007/BF02026712.
Twenty-four patients in a paediatric intensive care unit mostly undergoing cardiac surgery, received a midazolam dosage between 50-400 micrograms/kg per hour as a continuous intravenous infusion partly in combination with fentanyl [0,5-2,5 micrograms/kg per hour] for analgesia and sedation. The mean duration of midazolam infusion was 11.6 days (range 38 h-40 days). Blood samples for the HPLC assay of serum midazolam concentration were taken and the clearance estimated. The efficiency of sedation in correlation to the midazolam concentration was evaluated by a clinical sedation score. Serum midazolam concentrations between 100-400 micrograms/l were sufficient for sedation. Dosage had to be increased during therapy according to an increased midazolam clearance. The evaluation of the sedation score showed that sedation of artificially ventilated infants and young children can be established by continuous intravenous infusion of midazolam.
一家儿科重症监护病房的24名主要接受心脏手术的患者，以每小时50 - 400微克/千克的剂量持续静脉输注咪达唑仑，部分与芬太尼[每小时0.5 - 2.5微克/千克]联合使用以进行镇痛和镇静。咪达唑仑输注的平均持续时间为11.6天（范围38小时 - 40天）。采集血样用于高效液相色谱法测定血清咪达唑仑浓度并估算清除率。通过临床镇静评分评估与咪达唑仑浓度相关的镇静效果。血清咪达唑仑浓度在100 - 400微克/升之间足以实现镇静。治疗期间必须根据咪达唑仑清除率的增加而增加剂量。镇静评分的评估表明，通过持续静脉输注咪达唑仑可以对人工通气的婴幼儿进行镇静。
