Abstract
AbstractWe aim to develop evidence-based recommendations for intensivists caring for children admitted to intensive care units and requiring analgesia and sedation. A panel of national paediatric intensivists expert in the field of analgesia and sedation and other specialists (a paediatrician, a neuropsychiatrist, a psychologist, a neurologist, a pharmacologist, an anaesthesiologist, two critical care nurses, a methodologist) started in 2018, a 2-year process. Three meetings and one electronic-based discussion were dedicated to the development of the recommendations (presentation of the project, selection of research questions, overview of text related to the research questions, discussion of recommendations). A telematic anonymous consultation was adopted to reach the final agreement on recommendations. A formal conflict-of-interest declaration was obtained from all the authors. Eight areas of direct interest and one additional topic were considered to identify the best available evidence and to develop the recommendations using the Evidence-to-Decision framework according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. For each recommendation, the level of evidence, the strength of the recommendation, the benefits, the harms and the risks, the benefit/harm balance, the intentional vagueness, the values judgement, the exclusions, the difference of the opinions, the knowledge gaps, and the research opportunities were reported. The panel produced 17 recommendations. Nine were evaluated as strong, 3 as moderate, and 5 as weak. Conclusion: a panel of national experts achieved consensus regarding recommendations for the best care in terms of analgesia and sedation in critically ill children.
Publisher
Springer Science and Business Media LLC
Reference165 articles.
1. Playfor S, Jenkins I, Boyles C, Choonara I, Davies G, Haywood T, Hinson G, Mayer A, Morton N, Ralph T, Wolf A (2006) Consensus guidelines on sedation and analgesia in critically ill children. Intensive Care Med 32(8):1125–1136. https://doi.org/10.1007/s00134-006-0190-x
2. Mondardini MC, Vasile B, Amigoni A, Baroncini S, Conio A, Mantovani A, Corolli E, Ferrero F, Stoppa F, Vigna G, Lampugnani E, L’Erario M (2014) Update of recommendations for analgosedation in pediatric intensive care unit. Minerva Anestesiol 80(9):1018–1029
3. Lucas SS, Nasr VG, Ng AJ, Charlene J, Bond M, DiNardo JA (2016) Pediatric Cardiac Intensive Care Society 2014 Consensus Statement: pharmacotherapies in cardiac critical care: sedation, analgesia and muscle relaxant. Pediatr Crit Care Med 17(3 Suppl 1):S3–S15. https://doi.org/10.1097/PCC.0000000000000619
4. Harris J, Ramelet AS, van Dijk M, Pokorna P, Wielenga J, Tume L, Tibboel D, Ista E (2016) Clinical recommendations for pain, sedation, withdrawal and delirium assessment in critically ill infants and children: an ESPNIC position statement for healthcare professionals. Intensive Care Med 42(6):972–986. https://doi.org/10.1007/s00134-016-4344-1
5. Higgins JPT, Green S. Cochrane handbook for systematic reviews of interventions version 5.1.0 [updated March 2011]. Edited by: [http://www.cochrane-handbook.org]. Accessed 7 Mar 2019
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