Opioid and sedative use in extremely preterm infants receiving mechanical ventilation.

OBJECTIVE

Quantify opioid and sedative medication exposures in preterm infants receiving mechanical ventilation.

STUDY

DESIGN

Cohort study of infants <28 weeks' gestation receiving any mechanical ventilation in the first 28 postnatal days. We examined exposure to morphine, fentanyl, midazolam, and lorazepam. We used logistic regression to examine the association between daily respiratory support and probability of medication administration.

RESULTS

Of 36,067 infants, 15,025 (42%) received one or more medications. There was a decrease in exposure to fentanyl and benzodiazepines from 2012 to 2020. Major morbidities were lower in unexposed infants. The odds of receiving target medications were more than twice as high on high frequency mechanical ventilation days compared to conventional mechanical ventilation days (unadjusted odds ratio 2.47, 95% CI 2.36-2.59).

CONCLUSION

In preterm infants receiving mechanical ventilation, the use of opioids or sedatives was common and high frequency ventilation was associated with higher exposure to medications.