Incidencia del Síndrome de Abstinencia, aplicando la escala de WAT-1, en pacientes de 1 mes a 17 años, en la unidad de cuidados intensivos pediátricos del Hospital Roberto Gilbert Elizalde de Guayaquil, de marzo a agosto del 2020.

Abstract

Background: The prolonged usage of sedatives and analgesics in children not only produces a tolerance to drugs but also withdrawal syndrome upon ceasing usage. These side effects are directly related to usage over time and accumulation of sedation doses. After recording a high frequency of withdrawal syndrome in our subjects; our main objectives were to establish the real cause, determine the main risk factors for its presentation, and establish the doses of benzodiazepines and opiates required for the development of withdrawal syndrome. Materials and Methods: We conducted a prospective, observational and descriptive study of the presence of signs and symptoms of withdrawal using the WAT-1 scale. This study was conducted using 28 beds in the Pediatric Intensive Care Unit (PICU), at the Roberto Gilbert Elizalde Hospital, located in the city of Guayaquil. Our patients consisted of subjects that were admitted to the PICU between the months of March to August in 2020 and were also treated with benzodiazepines coupled with or without the addition of opiates for more than 48 hours. Records were kept for the number of days treated and the total accumulated doses taken. Our patients were divided into two groups; one group that consisted of patients with withdrawal syndrome and one group without it. The groups were analyzed for results. Results: Out of 100 patients: 24% presented withdrawal syndrome with an accumulated dose of 33 mg/kg of midazolam and 410 mcg/kg of fentanyl over seven days of application. Conclusions: There is a direct association between the development of withdrawal syndrome and the accumulated doses of benzodiazepines (with or without the addition of opiates) in children.