Intranasal fentanyl for respiratory distress in children and adolescents with life-limiting conditions

Abstract Background Respiratory distress is one of the most common and frightening symptoms of children with life-limiting conditions. Because treatment of the underlying cause is frequently impossible or insufficient, in many children, symptomatic treatment is warranted. The purpose of this study w...

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Main Authors:	Lucas Pieper, Julia Wager, Boris Zernikow
Format:	Article
Language:	English
Published:	BioMed Central 2018-09-01
Series:	BMC Palliative Care
Subjects:	Dyspnea Fentanyl Intranasal application Palliative Pediatric
Online Access:	http://link.springer.com/article/10.1186/s12904-018-0361-x

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spelling	doaj-art-4c27f82f9c67418994c1e08d96899ec02018-09-16T11:37:40ZengBioMed CentralBMC Palliative Care1472-684X2018-09-011711810.1186/s12904-018-0361-xIntranasal fentanyl for respiratory distress in children and adolescents with life-limiting conditionsLucas Pieper0Julia Wager1Boris Zernikow2Department of Children’s Pain Therapy and Paediatric Palliative Care, Witten/Herdecke University, Faculty of Health – School of MedicineDepartment of Children’s Pain Therapy and Paediatric Palliative Care, Witten/Herdecke University, Faculty of Health – School of MedicineDepartment of Children’s Pain Therapy and Paediatric Palliative Care, Witten/Herdecke University, Faculty of Health – School of MedicineAbstract Background Respiratory distress is one of the most common and frightening symptoms of children with life-limiting conditions. Because treatment of the underlying cause is frequently impossible or insufficient, in many children, symptomatic treatment is warranted. The purpose of this study was to describe the circumstances of the use of intranasal fentanyl in an acute attack of respiratory distress (AARD) in children receiving palliative care, as well as to describe outcomes and adverse events after its use. Methods Children and adolescents treated in a pediatric palliative unit or attended by a specialized home care team between 2010 and 2016 were included in this study. A retrospective chart review was conducted of those who were treated with intranasal fentanyl for an AARD. Results During the study period 16 children (0.5–18.6 years) with various life-limiting conditions were treated with intranasal fentanyl for AARD. In total, 70 AARDs were analyzed. In 74% of all AARDs, a single dose of intranasal fentanyl was used. Frequent causes for an AARD were excessive secretions and acute respiratory infection. The median starting dose of intranasal fentanyl was 1.5 μg/kg body weight. Labored breathing (96%), tachypnea (79%) and related suffering (97%) improved after treatment. An adverse event occurred in one child. Conclusions Intranasal fentanyl may be a safe and effective medication for the treatment of acute attacks of respiratory distress in children with life-limiting conditions. However, prospective studies with larger sample sizes and a control group are needed to validate these findings.http://link.springer.com/article/10.1186/s12904-018-0361-xDyspneaFentanylIntranasal applicationPalliativePediatric
institution	Open Data Bank
collection	Open Access Journals
building	Directory of Open Access Journals
language	English
format	Article
author	Lucas Pieper Julia Wager Boris Zernikow
spellingShingle	Lucas Pieper Julia Wager Boris Zernikow Intranasal fentanyl for respiratory distress in children and adolescents with life-limiting conditions BMC Palliative Care Dyspnea Fentanyl Intranasal application Palliative Pediatric
author_facet	Lucas Pieper Julia Wager Boris Zernikow
author_sort	Lucas Pieper
title	Intranasal fentanyl for respiratory distress in children and adolescents with life-limiting conditions
title_short	Intranasal fentanyl for respiratory distress in children and adolescents with life-limiting conditions
title_full	Intranasal fentanyl for respiratory distress in children and adolescents with life-limiting conditions
title_fullStr	Intranasal fentanyl for respiratory distress in children and adolescents with life-limiting conditions
title_full_unstemmed	Intranasal fentanyl for respiratory distress in children and adolescents with life-limiting conditions
title_sort	intranasal fentanyl for respiratory distress in children and adolescents with life-limiting conditions
publisher	BioMed Central
series	BMC Palliative Care
issn	1472-684X
publishDate	2018-09-01
description	Abstract Background Respiratory distress is one of the most common and frightening symptoms of children with life-limiting conditions. Because treatment of the underlying cause is frequently impossible or insufficient, in many children, symptomatic treatment is warranted. The purpose of this study was to describe the circumstances of the use of intranasal fentanyl in an acute attack of respiratory distress (AARD) in children receiving palliative care, as well as to describe outcomes and adverse events after its use. Methods Children and adolescents treated in a pediatric palliative unit or attended by a specialized home care team between 2010 and 2016 were included in this study. A retrospective chart review was conducted of those who were treated with intranasal fentanyl for an AARD. Results During the study period 16 children (0.5–18.6 years) with various life-limiting conditions were treated with intranasal fentanyl for AARD. In total, 70 AARDs were analyzed. In 74% of all AARDs, a single dose of intranasal fentanyl was used. Frequent causes for an AARD were excessive secretions and acute respiratory infection. The median starting dose of intranasal fentanyl was 1.5 μg/kg body weight. Labored breathing (96%), tachypnea (79%) and related suffering (97%) improved after treatment. An adverse event occurred in one child. Conclusions Intranasal fentanyl may be a safe and effective medication for the treatment of acute attacks of respiratory distress in children with life-limiting conditions. However, prospective studies with larger sample sizes and a control group are needed to validate these findings.
topic	Dyspnea Fentanyl Intranasal application Palliative Pediatric
url	http://link.springer.com/article/10.1186/s12904-018-0361-x
_version_	1612573267766280192

Intranasal fentanyl for respiratory distress in children and adolescents with life-limiting conditions

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