Use of Levomepromazine in Pediatric Intensive Care Units in Argentina: Survey on Indication Profiles
Main Article Content
Abstract
Objectives: To describe the use of levomepromazine in pediatric intensive care units (PICUs) across Argentina.
Design: Structured survey distributed via email and instant phone messaging to healthcare professionals working in pediatric intensive care units, including physicians, nurses, physical therapists, and pharmacists.
Setting: Public and private hospitals, either general or specialized in pediatric care.
Participants: All staff members actively engaged in clinical care within PICUs were invited to participate.
Intervention: None.
Results: A total of 116 responses were obtained from 154 professionals invited to participate (response rate 75%) from 13 PICUs nationwide. Levomepromazine was most commonly indicated as an adjuvant in analgesic sedation (49.7%), followed by its use in the treatment of delirium (37%), and as an antipsychotic-neuroleptic agent, while 3.2% employed it as a first-line agent for analgesic sedation or as an antiemetic. Since respondents could select more than one indication, the percentages are not mutually exclusive
Conclusions: Ninety-three percent of respondents reported regular use of levomepromazine in their units, suggesting that this drug is frequently and widely used in the surveyed PICUs.
Article Details
Section

This work is licensed under a Creative Commons Attribution 4.0 International License.
The magazine does not retain the reproduction rights (copyright) so the authors can republish their works with the sole mention of the original publication source.
How to Cite
References
Taffarel Pedro; Bonetto German; Jorro Baron F.; Meregalli C.; “Sedación y analgesia en pacientes con asistencia ventilatoria mecánica en unidades de cuidados intensivos pediátricos de Argentina”; Archivos Argentinos de Pediatría; 2018. Apr 1;116(2): e196-e203. doi: 10.5546/aap.2018.eng.e196.
Selandari J, Vera F, Filippini S. Tolerancia a analgo-sedantes y síndrome de abstinencia iatrogénico en UCIP. Curso E-CCri Comité Nacional de Emergencias y Cuidados Críticos. Sociedad Argentina de Pediatría, Argentina, 2014. Disponible en: AR-UCIP (Ayuda Rápida - UCIP y/o ARgentina - UCIP)
Sanger GJ, Andrews PLR. A History of Drug Discovery for Treatment of Nausea and Vomiting and the Implications for Future Research. Frontiers in Pharmacology [Internet]. 2018 Sep 4;9(9). Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6131675/
James P, Arenas-López S, Durward A, Snoek A. Levomepromazine for difficult sedation in pediatric intensive care. Journal of Pediatric Intensive Care. 2015 Jul 28;03(02):053–7. Disponible en: https://pmc.ncbi.nlm.nih.gov/articles/PMC6530745/
Green B, Pettit T, Faith L, Seaton K. Focus on levomepromazine. Current Medical Research and Opinion. 2004 Oct 28;20(12):1877–81. Disponible en: https://www.tandfonline.com/doi/10.1185/030079904X12708?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed
Eshel G, Usher M, Barr J, Heggesh R, Lahat E. Phenothiazine Treatment and Respiratory Distress Syndrome in a Child. Journal of Toxicology: Clinical Toxicology. 1994 Jan;32(2):191–7. Disponible en: https://pubmed.ncbi.nlm.nih.gov/8145359/
Becerra V.; Buamscha, D.; Ponce, C.; Cambaceres C.; Noman, A.; Galván M.E; Lenz, M. Levomepromazina como coadyuvante de sedación en la unidad de cuidados intensivos pediátricos. Rev. Arg. de Psiquiat. 2017, Vol. XXVIII: pp. 411-415. Disponible en: https://revistavertex.com.ar/ojs/index.php/vertex/article/view/399
Michel J, Schepan E, Hofbeck M, Engel J, Simma A, Neunhoeffer F. Implementation of a Delirium Bundle for Pediatric Intensive Care Patients. Frontiers in Pediatrics. 2022 Feb 7;10. Disponible en: https://pmc.ncbi.nlm.nih.gov/articles/PMC8859429/
Asociación Española de Pediatría, Comité de Medicamentos. Levomepromazina. En Pediamecum (1 de marzo de 2024). Disponible en: Levomepromazina | Asociación Española de Pediatría. Consultado 14 de septiembre de 2024
Hospital de Pediatría Garrahan. Consulta formulario farmacéutico - Garrahan. Disponible en https://farmacia.garrahan.gov.ar/Vademecum/Busqueda. Consultado 14 de septiembre de 2024
AA PHARMA INC. Methotrimeprazine maleate tables, prescribing information. Año 2012. Disponible en: Methoprene PI.pdf
Rojas S. V. S., Carranza R. A. R. Levomepromazina: una nueva opción terapéutica ante la abstinencia opioide. Revista Electrónica de PortalesMedicos.com, 18(23), diciembre de 2023. Disponible en: https://www.revista-portalesmedicos.com/revista-medica/levomepromazina-una-nueva-opcion-terapeutica-ante-la-abstinencia-opioide/
Schieveld JN, Staal M, Voogd L, Fincken J, Vos G, van Os J. Refractory agitation as a marker for pediatric delirium in very young infants at a pediatric intensive care unit. Intensive Care Medicine. 2010 Aug 6;36(11):1982–3. Disponible en: https://pmc.ncbi.nlm.nih.gov/articles/PMC2952108/
Van der Zwaan S, Blankespoor RJ, Wolters AMH, Creten C, Leroy PLJM, Schieveld JNM. Additional use of methotrimeprazine for treating refractory agitation in pediatric patients. Intensive Care Medicine. 2011 Nov 23;38(1):175–6. Disponible en: https://pmc.ncbi.nlm.nih.gov/articles/PMC3233662/
Amigoni A, Conti G, Conio A, Corno M, Fazio PC, Ferrero F, et al. Recomendations for analgesia and sedation in critically ill children admitted to intensive care unit. Journal of Anesthesia, Analgesia and Critical Care. 2022 Feb 12;2(1). Disponible en: https://pmc.ncbi.nlm.nih.gov/articles/PMC8853329/
Jaime Boceta Osuna; Rafael Cía Ramos; José Antonio Cuello Contreras; Miguel Duarte Rodríguez; Auxiliadora Fernández López; Reyes Sanz Amores; Elvira Fernández de la Mota. SEDACIÓN PALIATIVA Y SEDACIÓN TERMINAL Orientaciones para la Toma de Decisiones en la Práctica Clínica: documentos de apoyo. Consejería de Salud, Junta de Andalucía (2005), pp. 22-23. Disponible en: https://repositoriosalud.es/entities/publication/973aab56-c55d-4106-ba43-a3640c07b1dc
Registros Federales de Referencia de Establecimientos y Profesionales de la Salud. Disponible en: (https://www.argentina.gob.ar/salud/garantia-de-calidad-de-la-atencion-medica/registros-federales-de-referencia-de).
Rojas S. V. S., Carranza R. A. R. Levomepromazina: una nueva opción terapéutica ante la abstinencia opioide. Disponible en Revista Electrónica de PortalesMedicos.com 18(23). Consultado en diciembre de 2023.
Smith HAB, Besunder JB, Betters KA, Johnson PN, Srinivasan V, Stormorken A, Farrington E, Golianu B, Godshall AJ, Acinelli L, Almgren C, Bailey CH, Boyd JM, Cisco MJ, Damian M, deAlmeida ML, Fehr J, Fenton KE, Gilliland F, Grant MJC, Howell J, Ruggles CA, Simone S, Su F, Sullivan JE, Tegtmeyer K, Traube C, Williams S, Berkenbosch JW. 2022 Society of Critical Care Medicine Clinical Practice Guidelines on Prevention and Management of Pain, Agitation, Neuromuscular Blockade, and Delirium in Critically Ill Pediatric Patients with Consideration of the ICU Environment and Early Mobility. Pediatr. Crit. Care Med. 2022. 2022 Feb 1;23(2): e74-e110. doi: 10.1097/PCC.0000000000002873.