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Neonatal and paediatric intensive care

By Ghi Pei Khoo and Omonefe Bolton

The contribution of clinical pharmacists to the care of patients in the neonatal intensive care unit (NICU) and the paediatric intensive care unit (PICU) has been shown to improve the appropriate use of medicines and the detection of potential adverse events.1–3

The creation of a pharmacy team that co-ordinates the functions of dispensing, central intravenous additive (CIVA) services and pharmaceutical care makes it possible to provide a comprehensive pharmacy service that meets the needs of neonatal and paediatric intensive care patients.4

The NICU admits both premature neonates (ie, those born after less than 37 weeks gestation) and term neonates requiring surgical interventions or with complications, such as meconium aspiration, birth asphyxia and poor feeding.

The degree of neonatal immaturity reflects the severity of problems that can be encountered in these patients, such as poor temperature control and respiratory function, and susceptibility to infection. The altered drug handling and pharmacokinetic response to drugs in neonates compared with older children and adults has led to specific drug dosing and monitoring schedules for this patient population.5,6

The PICU admits children ranging from term neonates to 16-year-olds who require intensive care monitoring and support, such as ventilation. Problems in these children include respiratory failure, sepsis, third degree burns and serious head injuries.

The NICU and PICU are highly specialised and complex clinical areas that require a multidisciplinary team approach to the provision of patient care. Pharmacists are integral members of the multidisciplinary team, which includes medical staff, nursing staff, dietitians, physiotherapists, occupational therapists and speech therapists.7

Download the attached PDF to read the full article.

Citation: Hospital Pharmacist URI: 10976667

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