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Iatrogenic Withdrawal Syndrome: a Review of Pathophysiology, Prevention, and Treatment

  • Jessica M. LaRosaEmail author
  • Linda Aponte-Patel
Intensive Care Medicine (E Cheung and T Connors, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Intensive Care Medicine

Abstract

Purpose of Review

Iatrogenic withdrawal syndrome (IWS) is the direct result of sedative agents utilized to facilitate pediatric intensive care. The purpose of this review is to overview how sedative agents result in IWS and overview the assessment tools, prevention strategies, and treatments for the condition.

Recent Findings

Since the development of validated withdrawal assessment tools, there has been a focus on identifying IWS risk. The most significant IWS risk factors are duration of exposure to sedatives and total cumulative doses of these agents. Given these risk factors, there has been an effort to develop strategies to prevent IWS, which have not proven to be efficacious thus far. The utilization of these risk factors in the development of sedation tapering protocols has been successful in reducing the amount of exposure children have to sedative agents.

Summary

Iatrogenic withdrawal syndrome is common and is a necessary consequence of sedation needed in order to safely and effectively care for critically ill children. Newly identified risk factors may be helpful in expeditious tapering of sedatives without inducing withdrawal symptoms.

Keywords

Iatrogenic withdrawal syndrome Analgesia Sedation Pediatric intensive care Abstinence syndrome 

Notes

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

Papers of particular interest, published recently, have been highlighted as: •• Of major importance

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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Pediatrics, New York Presbyterian Morgan Stanley Children’s Hospital of New YorkColumbia University Irving Medical CenterNew YorkUSA

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