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Thiopental pharmacokinetics in newborn infants: a case report of overdose.

Norman, Elisabeth LU ; Malmqvist, Ulf LU ; Westrin, Per LU and Fellman, Vineta LU (2009) In Acta paediatrica (Oslo, Norway : 1992) 98. p.1680-1682
Abstract
Abstract Thiopental may be used for sedation before intubation in newborn infants. A boy, born at 33 weeks of gestation (gw); birth weight 2435 g, was prescribed thiopental 3 mg/kg before intubation. He developed temporary hypotension and oxygen desaturation, and remained unconscious for longer than expected with a suppressed electroencephalography for 48 h. Serum thiopental concentration was 82, 59, 42 and 32 mumol/L after 20 min and 6, 24 and 68 h respectively. Serum concentrations from five newborn infants at the same time points after intubation with the same thiopental dose were used as reference values, and indicated a 10-fold overdose in the index case. The cause of the overdose could not be identified. The infant recovered;... (More)
Abstract Thiopental may be used for sedation before intubation in newborn infants. A boy, born at 33 weeks of gestation (gw); birth weight 2435 g, was prescribed thiopental 3 mg/kg before intubation. He developed temporary hypotension and oxygen desaturation, and remained unconscious for longer than expected with a suppressed electroencephalography for 48 h. Serum thiopental concentration was 82, 59, 42 and 32 mumol/L after 20 min and 6, 24 and 68 h respectively. Serum concentrations from five newborn infants at the same time points after intubation with the same thiopental dose were used as reference values, and indicated a 10-fold overdose in the index case. The cause of the overdose could not be identified. The infant recovered; cerebral magnetic resonance imaging at the age of 42 gw and psychomotor development at 2 years were normal. These results show that thiopental concentrations are variable in neonates and there is a high risk of dosage error as no specific paediatric formulation is available. Conclusion: Well-designed procedures and continuous education are required to prevent errors and adverse events during drug delivery to newborn infants. To develop a safe method of administration for thiopental, an extended pharmacokinetic and pharmacodynamic study in neonates is warranted. (Less)
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author
organization
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type
Contribution to journal
publication status
published
subject
in
Acta paediatrica (Oslo, Norway : 1992)
volume
98
pages
1680 - 1682
publisher
Taylor & Francis
external identifiers
  • WOS:000269491100029
  • PMID:19583708
  • Scopus:69749119542
ISSN
1651-2227
DOI
10.1111/j.1651-2227.2009.01394.x
language
English
LU publication?
yes
id
704b00e4-e211-4116-821d-e1ef3b19ed7d (old id 1453324)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/19583708?dopt=Abstract
date added to LUP
2009-08-04 10:11:06
date last changed
2017-01-01 07:42:33
@article{704b00e4-e211-4116-821d-e1ef3b19ed7d,
  abstract     = {Abstract Thiopental may be used for sedation before intubation in newborn infants. A boy, born at 33 weeks of gestation (gw); birth weight 2435 g, was prescribed thiopental 3 mg/kg before intubation. He developed temporary hypotension and oxygen desaturation, and remained unconscious for longer than expected with a suppressed electroencephalography for 48 h. Serum thiopental concentration was 82, 59, 42 and 32 mumol/L after 20 min and 6, 24 and 68 h respectively. Serum concentrations from five newborn infants at the same time points after intubation with the same thiopental dose were used as reference values, and indicated a 10-fold overdose in the index case. The cause of the overdose could not be identified. The infant recovered; cerebral magnetic resonance imaging at the age of 42 gw and psychomotor development at 2 years were normal. These results show that thiopental concentrations are variable in neonates and there is a high risk of dosage error as no specific paediatric formulation is available. Conclusion: Well-designed procedures and continuous education are required to prevent errors and adverse events during drug delivery to newborn infants. To develop a safe method of administration for thiopental, an extended pharmacokinetic and pharmacodynamic study in neonates is warranted.},
  author       = {Norman, Elisabeth and Malmqvist, Ulf and Westrin, Per and Fellman, Vineta},
  issn         = {1651-2227},
  language     = {eng},
  pages        = {1680--1682},
  publisher    = {Taylor & Francis},
  series       = {Acta paediatrica (Oslo, Norway : 1992)},
  title        = {Thiopental pharmacokinetics in newborn infants: a case report of overdose.},
  url          = {http://dx.doi.org/10.1111/j.1651-2227.2009.01394.x},
  volume       = {98},
  year         = {2009},
}