A maturation model for midazolam clearance

Anderson, Brian J.; Larsson, Peter

doi:10.1111/j.1460-9592.2010.03364.x

Cited by 70 publications

(45 citation statements)

References 70 publications

(64 reference statements)

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“…The maturation model has been applied to predict clearance of several drugs such as morphine (5), propofol (6), and midazolam (7). The BDE model has been applied to predict clearance of morphine (8), propofol (9,10), and busulfan (11).…”

Section: Introductionmentioning

confidence: 99%

Prediction of Human Glomerular Filtration Rate from Preterm Neonates to Adults: Evaluation of Predictive Performance of Several Empirical Models

Mahmood

Staschen

2016

AAPS J

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Abstract. The objective of this study was to evaluate the predictive performance of several allometric empirical models (body weight dependent, age dependent, fixed exponent 0.75, a data-dependent single exponent, and maturation models) to predict glomerular filtration rate (GFR) in preterm and term neonates, infants, children, and adults without any renal disease. In this analysis, the models were developed from GFR data obtained from inulin clearance (preterm neonates to adults; n = 93) and the predictive performance of these models were evaluated in 335 subjects (preterm neonates to adults). The primary end point was the prediction of GFR from the empirical allometric models and the comparison of the predicted GFR with measured GFR. A prediction error within ±30% was considered acceptable. Overall, the predictive performance of the four models (BDE, ADE, and two maturation models) for the prediction of mean GFR was good across all age groups but the prediction of GFR in individual healthy subjects especially in neonates and infants was erratic and may be clinically unacceptable.

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Section: Introductionmentioning

confidence: 99%

Prediction of Human Glomerular Filtration Rate from Preterm Neonates to Adults: Evaluation of Predictive Performance of Several Empirical Models

Mahmood

Staschen

2016

AAPS J

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“…Since these processes display maturation, clearance is reduced with an elimination half-life of 12 h in the neonate, compared to 2 h in the adult. Anderson and Larsson [152] recently described a maturational model of midazolam clearance and extrapolated that a steady-state infusion rate of 0.014 mg/kg/h is needed to attain a sedation target concentration similar to findings in adults. However, this dosing suggestion has not been validated while there are only a limited number of observations of midazolam in the neonate.…”

Section: Benzodiazepinesmentioning

confidence: 85%

“…Consequently, population-specific dosing is required, and accumulation is more likely in neonates [152,153].…”

Section: Take-home Messagesmentioning

confidence: 99%

Sedation in the Neonatal Intensive Care Unit: International Practice

Allegaert

Anker

2014

Pediatric Sedation Outside of the Operating Room

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Inadequate pain management in neonatal life impairs neurodevelopmental outcome because it alters pain thresholds, pain-or stress-related behavior, and physiological responses later in life. However, there are recently also emerging animal experimental and human epidemiological data on the impact of analgo-sedatives on neuro-apoptosis and impaired neurodevelopmental outcome. As a consequence, the management of neonatal pain is in search of a new balance, and these conflicting observations are the main drivers to tailor our pain management in neonates. Adequate pain management is based on prevention, assessment, and treatment with subsequent reassessment. Issues related to prevention and assessment tools are covered. Non-pharmacological (e.g., complementary interventions like facilitated tucking, nonnutritive sucking) and pharmacological (e.g., acetaminophen, opioids, ketamine, propofol) treatment modalities were reviewed and reflect the increased knowledge on neonatal pain management. Each topic ends with some take-home messages that in part also reflect our opinion on the current status of this topic.

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“…The precision of the methods was measured by calculating the mean absolute error according to Eq. [8]:…”

Section: Discussionmentioning

confidence: 98%

“…In recent years, to predict clearance and volume of distribution of drugs in the pediatric population, a maturation model has been proposed. This model has been applied to several drugs such as morphine (7) , midazolam (8) , and propofol (9) . However, the predictive performance of the maturation models has not been evaluated with data which were not included in building the model.…”

Section: Introductionmentioning

confidence: 99%