Conversion From Continuous Infusion Fentanyl to Continuous Infusion Hydromorphone in the Pediatric ICU
pubmed.ncbi.nlm.nih.govA median 14% fentanyl dose reduction was noted when transitioning to hydromorphone. Further exploration is needed to determine if opioid rotations with hydromorphone can reduce opioid/sedative exposure.
A total of 36 children were converted to hydromorphone.
The median conversion percentage of hydromorphone was 86% of their fentanyl dose (interquartile range [IQR] = 67-100).
The median hydromorphone rate at stabilization was 0.08 mg/kg/h (IQR = 0.05-0.1).
Eight (22%) were stabilized on their initial hydromorphone rate; 8 (22%) never achieved stabilization.
Patients had a significant decrease in opioid dosing on the day of conversion versus the 24-hour period prior to conversion but no changes in sedative dosing following conversion.