Sedation Problems on CVVH?

Specialties PICU

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Specializes in peds critical care, peds GI, peds ED.

Anyone out there have issues sedating their kids who are on CVVH? What do you use? How much?

:banghead: We feel like we are hitting our heads against a brick wall to keep these kids down (and to keep them from clotting their circuits off!).

Specializes in pediatrics/PICU.

Fentanyl, versed and vec if you need it (only on tubed kids!). If they are clotting off their lines, they need to go down! When you get to the point that you need CVVH, then they should be tubed and the medical staff should be in control, not the patient. Hope this helps. All our kids are tubed it they are that sick!

Specializes in peds critical care, peds GI, peds ED.

Most of our kids are intubated as well, but we still have a difficult time keeping them sedated. We use vec all the time, but our docs do not paralyze as a standard of practice. We usually have to beg, unless they are on HFOV.

Thanks for your comments.

Versed and fentanyl drips with prn boluses available is what we use while patients are on CRRT.

Specializes in PICU.
Anyone out there have issues sedating their kids who are on CVVH? What do you use? How much?

:banghead: We feel like we are hitting our heads against a brick wall to keep these kids down (and to keep them from clotting their circuits off!).

We have this problem with the smaller kids- the regular sedation doses we would give to them gets metabolized way too quickly when on the circuit. You can usually get them under control though just by giving much higher doses

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