This article is more than 5 years old. Information may no longer be current.
PICU care increasingly needed for accidental opioid ingestions
Click Here to Manage Email Alerts
Although the number of pediatric deaths related to opioid ingestions decreased between 2004 and 2015, the number of children requiring care from a pediatric ICU increased dramatically from 24.9 to 35.9 per 10,000 PICU admissions.
“Despite the fact that the death rate from overdose has plateaued recently for adults, hospitalizations for opioid poisonings are actually increasing, especially among preschool children and adolescents,” Jason M. Kane, MD, MS, FAAP, FCCM, associate professor of pediatrics, interim chief in the section of critical care and director of quality and outcomes within the PICU at the University of Chicago Medicine Comer Children’s Hospital, told Infectious Diseases in Children.
“More disturbing is that the number of children admitted to the hospital for opioid-related admissions nearly doubled between 2004 and 2015,” he continued. “Although only 12% of the 4.1 million patients reviewed in this study required PICU care, almost half of the children admitted to the hospital with opioid poisonings required PICU care.”
To examine trends of pediatric opioid ingestions requiring critical care in U.S. children’s hospitals, the researchers conducted a retrospective cohort study that used data collected from the Pediatric Health Information System. Information was collected on pediatric hospitalizations for opioid ingestions between 2004 and 2015. Additionally, billing data was assessed for information regarding PICU admission, the administration of naloxone or vasopressors and ventilation use.
Of the 3,647 pediatric hospitalizations in 31 hospitals related to opioid ingestion, cases increased from 797 between 2004 and 2007 to 1,504 between 2012 and 2015. PICU care was required for 42.9% of the hospitalizations, with an overall mortality rate of 1.6% observed. Between 2004 and 2015, annual deaths decreased from 2.8% to 1.3% (P < .001); however, the number of children hospitalized that required PICU care rose from 24.9 to 35.9 per 10,000 PICU admissions (P < .001). Mechanical ventilators were needed for 37.0% of the children admitted to the PICU, and 20.3% needed vasopressors.
“I suggest that pediatricians continue to provide anticipatory guidance that they regularly provide to families. What we do not understand is why exploratory ingestions of opioids in young children are increasing when other medication classes are not seeing the same increases,” Kane said. “This may be related to the fact that there are more opioids in homes, reflecting the adult opioid crisis.”
“It is notable that from 2000-2007, U.S. DEA data showed a 559% increase in prescriptions for methadone,” he continued. “Our data revealed that 20% of children younger than 6 years admitted with opioid ingestions ingested methadone specifically.” – by Katherine Bortz
Disclosures: Kane reports no relevant financial disclosures. Please see the study for a full list of other author’s relevant financial disclosures.
Click Here to Manage Email Alerts