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[儿科重症监护病房中的药物不良反应]

[Adverse drug reactions in a paediatric intensive care unit].

作者信息

Telechea H, Speranza N, Lucas L, Giachetto G, Nanni L, Menchaca A

机构信息

Departamento de Farmacología y Terapéutica, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay.

出版信息

Farm Hosp. 2012 Sep-Oct;36(5):403-9. doi: 10.1016/j.farma.2011.08.007. Epub 2012 Aug 4.

Abstract

OBJECTIVE

To determine ADR frequency and characteristics of ADR in a paediatric intensive care unit between may and june 2009.

METHOD

All of the hospitalised children were under intensive pharmacosurveillance by means of daily analysis of their prescription profiles. The following patient characteristics were analysed: age, sex, drugs involved, affected organs and systems, triggered illness, adverse reaction mechanism, presence of polypharmacy, severity and course of the reaction. The following variables were recorded for adverse reactions: frequency, incidence in hospitalised children, incidence per 100 children/day and percentage of preventable reactions.

RESULTS

Of the 123 hospitalised children, 24 experienced at least one adverse reaction. The total number of identified adverse drug reactions was 45. Average age was 34 months, and 14 patients were male.Frequency was 36.6% (CI 95% 28.4-46.4). Adverse reaction average was calculated at 1.9 reactions per child. The ADR incidence rate per 100 children/day was 10.4. There were 66 drugs involved; the most common drug groups were antiepileptics and diuretics. Drug reactions most frequently affected the metabolic and haematological systems. Of the reactions, 61% were preventable. Twelve reactions were severe and 1 patient died.

CONCLUSIONS

Adverse reactions are a frequent health problem among critically ill children. There is a pressing need to create awareness and prevention strategies to decrease their frequency and severity.

摘要

目的

确定2009年5月至6月期间儿科重症监护病房的药物不良反应(ADR)发生率及特点。

方法

通过每日分析住院儿童的用药情况,对所有住院儿童进行强化药物监测。分析以下患者特征:年龄、性别、涉及药物、受累器官和系统、引发疾病、不良反应机制、联合用药情况、反应的严重程度和病程。记录以下不良反应变量:发生率、住院儿童中的发病率、每100名儿童/天的发病率以及可预防反应的百分比。

结果

123名住院儿童中,24名至少经历了一次不良反应。确定的药物不良反应总数为45例。平均年龄为34个月,14名患者为男性。发生率为36.6%(95%置信区间28.4 - 46.4)。每名儿童的不良反应平均数计算为1.9次。每100名儿童/天的ADR发病率为10.4。涉及66种药物;最常见的药物类别是抗癫痫药和利尿剂。药物反应最常影响代谢和血液系统。其中61%的反应是可预防的。12例反应严重,1例患者死亡。

结论

不良反应是危重症儿童中常见的健康问题。迫切需要提高认识并制定预防策略,以降低其发生率和严重程度。

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