Table 2.
Diagnoses and Outcomes
| Infant | GA (weeks) | BW (g) | Diagnoses | Indication | Concurrent neurological medications | Starting dose1 | Died | Discharge dose1 | Outcome |
|---|---|---|---|---|---|---|---|---|---|
| 1 | 23 | 670 | IVH with shunt, seizures, tracheostomy, GJ-tube | feeding intolerance/seizures | levetiracetam | 5 q8 | No | 5 q24 | Improved feeding tolerance. Tachycardia, emesis, and agitation with abrupt discontinuation when NPO |
| 2 | 24 | 430 | IVH with shunt, seizures, tracheostomy, G-tube | visceral hyperalgesia/agitation | clonidine, diazepam, acetaminophen PRN | 10 q12 | No | 10 q8 | Improved feeding tolerance |
| 3 | 24 | 860 | CLD, G-tube, GERD, hypertonia | visceral hyperalgesia/seizures | phenobarbital, diazepam, methadone, morphine PRN, lorazepam PRN | 5 q12 | Yes | Died | Decreased irritability and reduced use of benzodiazepines and morphine |
| 4 | 24 | 790 | CLD, G-tube, GERD, hypertonia | visceral hyperalgesia/agitation | baclofen | 5 q12 | No | 5 q12 | Decreased irritability, improved oral feeding and toleration of G-tube feeds. Tachycardia, emesis, and agitation with abrupt discontinuation when NPO |
| 5 | 26 | 890 | CLD, hypertonia, G-tube, bowel obstruction, twin | visceral hyperalgesia/agitation | baclofen, lorazepam | 5 q12 | No | 2.5 q12 | Bradycardia: resolved with lower dose; weaned off of benzodiazepines |
| 6 | 26 | 890 | CLD, hypertonia, G-tube, twin | visceral hyperalgesia/agitation | baclofen, lorazepam | 5 q12 | No | N/a | Bradycardia: discontinued without trial of lower dose |
| 7 | 27 | 1003 | Congenital intestinal atresia, microcephaly, lissencephaly, seizures, tracheostomy, GJ-tube | visceral hyperalgesia/agitation | diazepam, phenobarbital, topiramate, baclofen, lorazepam PRN | 5 q24 | No | 7.5 q12 | Decreased sympathetic hyperactivity; weaned off of benzodiazepines |
| 8 | 32 | 1900 | Pulmonary hypoplasia with tracheostomy, joint contractures, G-tube | visceral hyperalgesia/agitation | baclofen, clonidine, lorazepam PRN | 5 q12 | No | 5 q8 | Bradycardia which resolved at lower dose; weaned off of benzodiazepines and methadone |
| 9 | 38 | 3500 | HIE, hypertonia, GERD, G-tube | visceral hyperalgesia/agitation | baclofen, lorazepam PRN | 5 q8 | No | 7.5 q12 | Decreased irritability and improved oral feeding |
| 10 | 39 | 2940 | CDH, history of ECMO, tracheostomy, GJ-tube, NAS, seizures | visceral hyperalgesia/agitation/seizures | clonidine, lorazepam, methadone, phenobarbital | 5 q12 | No | N/a | Decreased irritability and use of benzodiazepines |
| 11 | 41 | 2921 | VATER syndrome, pulmonary hypoplasia with tracheostomy, chromosomal abnormality, G-tube, NAS, seizures | agitation/seizures | clonidine, diazepam, levetriracetam, oxcarbazepine, phenobarbital, dexmedetomidine gtt, midazolam gtt | 5 q8 | No | 5 q8 | Decreased irritability |
1
mg/kg weight dosing with hourly dosing
Abbreviations: CDH- congenital diaphragmatic hernia; CLD-chronic lung disease; ECMO- extracorporeal membrane oxygenation; EEG- electroencephalogram; GERD- gastroesophageal reflux disease; G-tube- gastrostomy tube; GJ tube-gastro-jejunostomy tube; HIE-hypoxic ischemic encephalopathy; IVH-intraventricular hemorrhage; NAS- neonatal abstinence syndrome