Authors: Brady S Moffett Antonio R Mott David P Nelson Karen D Gurwitch
Publish Date: 2007/12/14
Volume: 29, Issue: 4, Pages: 744-748
Abstract
Pediatric patients who have undergone cardiac surgery are at risk for renal insufficiency The impact of pharmacist consultation in the pediatric cardiac intensive care unit ICU has yet to be defined Patients admitted to the pediatric cardiac ICU at our institution from January through March of 2006 were included Patient information collected retrospectively included demographics cardiac lesion/surgery height weight need for peritoneal or hemodialysis need for mechanical support highest and lowest serum creatinine ICU length of stay LOS renally eliminated medications pharmacist recommendations accepted or not and appropriateness of dosing changesThere were 140 total admissions 131 patients age 30 ± 63 years during the study period In total 14 classes of renally eliminated medications were administered with 326 ± 564 doses administered per patient admission Thirtyseven patient admissions had one or more medications adjusted for renal insufficiency the most commonly adjusted medication was ranitidine Patients who required medication adjustment for renal dysfunction were significantly younger compared to those patients not requiring medication adjustment Pharmacist recommendations were responsible for 96 of medication adjustments for renal dysfunction and the recommendations were accepted and appropriate all of the time The monetary impact of pharmacist interventions in doses saved was approximately 12000 Pharmacist consultation can result in improved dosing of medications and cost savings The youngest patients are most at risk for inappropriate dosing
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