SCCM Resource Library-Special Considerations in Sedation and Analgesia in Children With Liver Failure

Special Considerations in Sedation and Analgesia in Children With Liver Failure

Video Transcription

Video Summary

The speaker discusses special considerations in sedation and analgesia for children with liver failure, highlighting pharmacokinetic changes in liver failure impacting drug use. They emphasize the understanding of liver functions to determine drug suitability in liver failure, differentiating between acute liver failure and cirrhosis. The Child-Pugh classification and MELD score are tools used for medication dosing in these conditions, but most drugs consider the Child-Pugh score. The impact of liver shunting and decreased plasma proteins on drug metabolism is discussed, as well as considerations for specific drugs like acetaminophen and NSAIDs. Acetaminophen is preferred over NSAIDs due to renal impact. For pain management, fentanyl is favored for its lack of active metabolites, while opioids like morphine should be used cautiously due to prolonged effects in liver impairment. Propofol and dexmedetomidine are considered for sedation due to their favorable metabolism in liver failure. The importance of considering the stage of liver disease in drug management is emphasized.

Asset Caption

One-Hour Concurrent Session | Joint SCCM-ESPNIC Session: Because You Can Does Not Mean You Should: How Far Can One Go in Liver ICU?

Meta Tag

Content Type Presentation

Membership Level Professional

Membership Level Select

Year 2024

Keywords

pediatric sedation

liver failure pharmacokinetics

Child-Pugh classification

acetaminophen vs NSAIDs

fentanyl for pain management

propofol and dexmedetomidine

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