Benedicta Tabacco1, Claudio Tacconi2, Angela Amigoni3. 1. Department of Pediatrics, Pediatric Intensive Care Unit, University of Padua, Padua, Italy - benedicta.tabacco@sanita.padova.it. 2. Department of Anesthesiology, Intensive Care Unit, University of Bologna, Bologna, Italy. 3. Department of Pediatrics, Pediatric Intensive Care Unit, University of Padua, Padua, Italy.
Abstract
BACKGROUND: Admission in Pediatric Intensive Care Unit requires management and monitoring of analgesia and sedation, in order to reduce their adverse effects, and to prevent withdrawal syndrome and delirium. The aim of this study was to evaluate the management of analgesia and sedation in critically ill children admitted in the Italian Pediatric Intensive Care Units. METHODS: For this survey we have submitted a telematics questionnaire to 24 nursing coordinators of the Pediatric Intensive Care Units or Neonatal Intensive Care Units admitting critically ill children. RESULTS: Twenty Intensive Care Units (ICUs) replied to the questionnaire. The association of benzodiazepines and opioids was the first choice in 92.8% of analgesic and sedative strategies. Seventy percent of ICUs adopted a protocol for analgesic and sedative drugs used before performing invasive and/or painful procedures in critically ill children. Ninety percent of them followed a protocol for the assessment of pain, 75% adopting the Face, Legs, Activity, Cry, Consolability Scale. Sixty percent of ICUs followed a protocol for sedation, 58% used the Comfort Scale to monitor the level of it. Forty percent adopted a protocol for the withdrawal syndrome, 75% of them monitored the patients with the WAT-1 Scale. Ten percent of Pediatric Intensive Care Units followed a protocol for management of delirium; seventy-five percent did not monitor it. CONCLUSIONS: Despite an increasing sensitivity in pain and sedation management over the last five years, knowledge and monitoring of abstinence syndrome and delirium need to be improved.
BACKGROUND: Admission in Pediatric Intensive Care Unit requires management and monitoring of analgesia and sedation, in order to reduce their adverse effects, and to prevent withdrawal syndrome and delirium. The aim of this study was to evaluate the management of analgesia and sedation in critically ill children admitted in the Italian Pediatric Intensive Care Units. METHODS: For this survey we have submitted a telematics questionnaire to 24 nursing coordinators of the Pediatric Intensive Care Units or Neonatal Intensive Care Units admitting critically ill children. RESULTS: Twenty Intensive Care Units (ICUs) replied to the questionnaire. The association of benzodiazepines and opioids was the first choice in 92.8% of analgesic and sedative strategies. Seventy percent of ICUs adopted a protocol for analgesic and sedative drugs used before performing invasive and/or painful procedures in critically ill children. Ninety percent of them followed a protocol for the assessment of pain, 75% adopting the Face, Legs, Activity, Cry, Consolability Scale. Sixty percent of ICUs followed a protocol for sedation, 58% used the Comfort Scale to monitor the level of it. Forty percent adopted a protocol for the withdrawal syndrome, 75% of them monitored the patients with the WAT-1 Scale. Ten percent of Pediatric Intensive Care Units followed a protocol for management of delirium; seventy-five percent did not monitor it. CONCLUSIONS: Despite an increasing sensitivity in pain and sedation management over the last five years, knowledge and monitoring of abstinence syndrome and delirium need to be improved.
Authors: Letícia Massaud-Ribeiro; Maria Clara de Magalhães Barbosa; Anderson Gonçalves Panisset; Jaqueline Rodrigues Robaina; Fernanda Lima-Setta; Arnaldo Prata-Barbosa; Antonio José Ledo Alves da Cunha Journal: Rev Bras Ter Intensiva Date: 2021 Jan-Mar
Authors: Marco Daverio; Florian von Borell; Angela Amigoni; Erwin Ista; Anne-Sylvie Ramelet; Francesca Sperotto; Paula Pokorna; Sebastian Brenner; Maria Cristina Mondardini; Dick Tibboel Journal: Crit Care Date: 2022-03-31 Impact factor: 9.097