Correction to: Pain and sedation management and monitoring in pediatric intensive care units across Europe: an ESPNIC survey

Daverio, Marco; Borell, Florian von; Ramelet, Anne‐Sylvie; Sperotto, Francesca; Pokorna, Paula; Brenner, Sebastian; Mondardini, Maria Cristina; Tibboel, Dick; Amigoni, Angela; Ista, Erwin

doi:10.1186/s13054-022-03992-4

Cited by 4 publications

(7 citation statements)

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“…The recent SCCM-PANDEM guidelines suggest that alpha agonists should be the primary sedative class for PICU sedation, with dexmedetomidine for cardiac surgical patients expected to extubate early (2). However, a recent Europe-wide study found that alpha agonists made up part of the rst choice sedative regimen in 18% of PICUs surveyed, although this only included 3 responses from the United Kingdom (10). Between 10 and 17% of respondents in our survey (dependent on patient category) reported using clonidine in > 75% of patients which appears to be consistent with the ndings of the European survey (10).…”

Section: Discussionsupporting

confidence: 87%

“…However, a recent Europe-wide study found that alpha agonists made up part of the rst choice sedative regimen in 18% of PICUs surveyed, although this only included 3 responses from the United Kingdom (10). Between 10 and 17% of respondents in our survey (dependent on patient category) reported using clonidine in > 75% of patients which appears to be consistent with the ndings of the European survey (10). The most recent North American-focussed study was in 2014, and showed a continuing predominance of opiate/benzodiazepine combination for rst choice analgo-sedation, alpha agonists being rst choice in 8% of units surveyed, although this may have changed in the subsequent years (11).…”

Section: Discussionmentioning

confidence: 99%

“…It is of interest that, despite recent safety concerns regarding the use of chloral hydrate for sedation, only 12-26% of respondents reported never using chloral hydrate and 13-27% of respondents reported using it in almost all patients. In the recent European survey Chloral hydrate was only used as rst choice in 1% of units, used for di cult sedation in 16% (10). There are no Food and Drug Administration (FDA) approved products containing chloral hydrate available for use in North America and its use there is highly restricted (12).…”

Section: Discussionmentioning

confidence: 99%

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A national survey of sedation practice and clinicians’ attitudes regarding sedation-related research in United Kingdom paediatric intensive care units

Mitting

Tume

Ramnarayan

2022

Preprint

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PurposeResearch involving analgo-sedation is a priority for both parents and professionals in paediatric intensive care, and guidelines are based on low quality evidence. Previous attempts at large-scale trials have faced recruitment challenges. Future research will require an understanding of current practice, research priorities of healthcare professionals and acceptability to parents. This survey aimed to describe current United Kingdom analgo-sedation practice, assess priorities for future research and identify perceived barriers to trials. MethodsA 26-question web-based survey was emailed to all Paediatric Critical Care Society members (n=1000) in April/May 2021. Responses were analysed both by ‘unit’ or at individual respondent level. Questions related to 4 patient categories: ‘neonatal (< 3 months of age) ‘paediatric’ > 3 months of age, ‘cardiac’ and ‘non-cardiac’.ResultsTwo hundred and sixteen healthcare professionals answered at least one question and responses were available from 100% of UK paediatric intensive care units (n=29) for all questions. Most units (96%, 28/29) routinely use scoring systems for sedation adequacy and presence of withdrawal (72%, 21/29), but few routinely screen for delirium (24%, 7/29). The most highly prioritised outcome measure for future trials was duration of mechanical ventilation. Respondents were most likely to agree to randomise paediatric general intensive care patients to trials comparing two different alpha agonists, and least likely to randomise neonatal cardiac patients to trials comparing benzodiazepines with alpha agonists. The most common perceived barrier to research was unit preference or familiarity with a particular regimen, followed by the perception that parents would not provide consent.ConclusionsThis study provides a snapshot of current United Kingdom analgo-sedation practice, and highlights the importance of parent/patient involvement in planning future trials.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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A national survey of sedation practice and clinicians’ attitudes regarding sedation-related research in United Kingdom paediatric intensive care units

Mitting

Tume

Ramnarayan

2022

Preprint

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“…Sie bildet ein evidenzbasiertes Gerüst für den klinischen Alltag [3]. Eine aktuelle Übersicht über europäische Kinderintensivstationen aus 27 Ländern beschreibt vorliegende Konzepte [11].…”

Section: Entwicklung Analgosedativer Konzepte In Der Pädiatrieunclassified

Analgesie und Sedierung bei Kindern

Richter¹

2022

Intensivmedizin up2date

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(Analgo-)Sedierungsprotokolle helfen, Kinder optimal schmerztherapeutisch zu versorgen. Im Vordergrund stehen die Reduktion der Schmerzreize im klinischen Alltag, die frühzeitige analgetische Therapie mit peripher wirkenden Schmerzmedikamenten oder in Kombination mit Opioidanalgetika nach dem Leitsatz „frühzeitig, ausreichend stark behandeln“. Die medikamentöse Therapie sollte immer in ein protokolliertes, multimodales (Schmerz-)Sedierungskonzept eingebettet sein, das auch ein Ausschleichen der Behandlung beinhaltet.

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“…Many repeated pain stimuli will cause stress reactions to the body, leading to a series of short-term and long-term adverse effects on neonates. [6][7][8] Non-drug interventions play an important role in neonatal pain management due to their simplicity and less adverse effects. In the sound environment of the fetus, the mother's voice plays a leading role.…”

Section: Introductionmentioning

confidence: 99%

Maternal voice reduces procedural pain in neonates: A meta-analysis of randomized controlled trials

Jin

Zhang²,

Yang³

et al. 2023

Medicine

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Background: Procedural pain management is a very important part in the clinical care of neonates. We aimed to conduct a meta-analysis to evaluate the effects of maternal voice on neonatal procedural pain, to provide insights to the clinical pain care of neonates. Methods: Two researchers independently searched PubMed, EMBASE, The Cochrane Library, CINAHL, Web of Science, China Biomedical Literature Database, China National Knowledge Infrastructure, Wanfang and Weipu Database for randomized controlled trials (RCTs) involving the effects of maternal voice on the procedural pain of neonates up to October 25, 2022. Two investigators screened the literature based on the inclusion and exclusion criteria and evaluated the methodological quality of the inclusion study. RevMan 5.3 software was used for the meta-analysis. Results: A total of 8 RCTs with a total of 584 neonates were included. Our meta-analysis indicated that maternal voice reduces the pain score (SMD = −0.60, 95% CI: −0.81 to −0.39) and heart rate (SMD = −0.81, 95% CI: −1.44 to −0.18) and increases the comfort level (SMD = −0.47, 95% CI: −0.83 to −0.11) and blood oxygen saturation (SMD = 0.70, 95% CI: 0.03–1.38) during procedure (all P < .05). Moreover, maternal voice reduces the pain score (SMD = −0.58, 95% CI: −0.88 to −0.28) and heart rate (SMD = −0.44, 95% CI: −0.75 to −0.12) and increases the blood oxygen saturation (SMD = 0.41, 95% CI: 0.00 to −0.82) after procedure (all P < .05). No publication biases were detected by the funnel plots and Egger tests (all P > .05). Conclusion: Maternal voice is beneficial to reduce procedural pain and improve the physiological indicators in neonates. It is still necessary to conduct high-quality, large sample studies in the future to further elucidate the effect of maternal voice on neonatal pain care.

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Correction to: Pain and sedation management and monitoring in pediatric intensive care units across Europe: an ESPNIC survey

Cited by 4 publications

References 1 publication

A national survey of sedation practice and clinicians’ attitudes regarding sedation-related research in United Kingdom paediatric intensive care units

A national survey of sedation practice and clinicians’ attitudes regarding sedation-related research in United Kingdom paediatric intensive care units

Analgesie und Sedierung bei Kindern

Maternal voice reduces procedural pain in neonates: A meta-analysis of randomized controlled trials

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