SanteMusiqueV1, Main, Exploration, bibRecord, 000B55

Survey of Sedation and Analgesia Practice Among Canadian Pediatric Critical Care Physicians.

Identifieur interne : 000B55 ( Main/Exploration ); précédent : 000B54; suivant : 000B56

Survey of Sedation and Analgesia Practice Among Canadian Pediatric Critical Care Physicians.

Auteurs : Gonzalo Garcia Guerra [Canada] ; Ari R. Joffe ; Dominic Cave ; Jonathan Duff ; Shannon Duncan ; Cathy Sheppard ; Gerda Tawfik ; Lisa Hartling ; Hsing Jou ; Sunita Vohra

Source :

Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies [ 1529-7535 ] ; 2016.

RBID : pubmed:27467012

Descripteurs français

English descriptors

KwdEn :
- Analgesia (methods), Analgesia (statistics & numerical data), Canada (MeSH), Child (MeSH), Clinical Protocols (MeSH), Conscious Sedation (methods), Conscious Sedation (statistics & numerical data), Critical Care (methods), Critical Care (statistics & numerical data), Drug Utilization (statistics & numerical data), Health Care Surveys (MeSH), Healthcare Disparities (statistics & numerical data), Humans (MeSH), Intensive Care Units, Pediatric (MeSH), Pediatrics (MeSH), Practice Patterns, Physicians' (statistics & numerical data).
MESH :
- methods : Analgesia, Conscious Sedation, Critical Care.
- statistics & numerical data : Analgesia, Conscious Sedation, Critical Care, Drug Utilization, Healthcare Disparities, Practice Patterns, Physicians'.
- Canada, Child, Clinical Protocols, Health Care Surveys, Humans, Intensive Care Units, Pediatric, Pediatrics.

Abstract

BACKGROUND

Despite the fact that almost all critically ill children experience some degree of pain or anxiety, there is a lack of high-quality evidence to inform preferred approaches to sedation, analgesia, and comfort measures in this environment. We conducted this survey to better understand current comfort and sedation practices among Canadian pediatric intensivists.

METHODS

The survey was conducted after a literature review and initial focus groups. The survey was then pretested and validated. The final survey was distributed by email to 134 intensivists from 17 PICUs across Canada using the Research Electronic Data Capture system.

RESULTS

The response rate was 73% (98/134). The most commonly used sedation scores are Face, Legs, Activity, Cry, and Consolability (42%) and COMFORT (41%). Withdrawal scores are commonly used (65%). In contrast, delirium scores are used by only 16% of the respondents. Only 36% of respondents have routinely used sedation protocols. The majority (66%) do not use noise reduction methods, whereas only 23% of respondents have a protocol to promote day/night cycles. Comfort measures including music, swaddling, soother, television, and sucrose solutions are frequently used. The drugs most commonly used to provide analgesia are morphine and acetaminophen. Midazolam and chloral hydrate were the most frequent sedatives.

CONCLUSION

Our survey demonstrates great variation in practice in the management of pain and anxiety in Canadian PICUs. Standardized strategies for sedation, delirium and withdrawal, and sleep promotion are lacking. There is a need for research in this field and the development of evidence-based, pediatric sedation and analgesia guidelines.

DOI: 10.1097/PCC.0000000000000864
PubMed: 27467012

Affiliations:

Canada

Links toward previous steps (curation, corpus...)

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Le document en format XML

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<term>Analgesia (statistics & numerical data)</term>
<term>Canada (MeSH)</term>
<term>Child (MeSH)</term>
<term>Clinical Protocols (MeSH)</term>
<term>Conscious Sedation (methods)</term>
<term>Conscious Sedation (statistics & numerical data)</term>
<term>Critical Care (methods)</term>
<term>Critical Care (statistics & numerical data)</term>
<term>Drug Utilization (statistics & numerical data)</term>
<term>Health Care Surveys (MeSH)</term>
<term>Healthcare Disparities (statistics & numerical data)</term>
<term>Humans (MeSH)</term>
<term>Intensive Care Units, Pediatric (MeSH)</term>
<term>Pediatrics (MeSH)</term>
<term>Practice Patterns, Physicians' (statistics & numerical data)</term>
</keywords>
<keywords scheme="KwdFr" xml:lang="fr"><term>Analgésie (méthodes)</term>
<term>Analgésie (statistiques et données numériques)</term>
<term>Canada (MeSH)</term>
<term>Disparités d'accès aux soins (statistiques et données numériques)</term>
<term>Enfant (MeSH)</term>
<term>Enquêtes sur les soins de santé (MeSH)</term>
<term>Humains (MeSH)</term>
<term>Protocoles cliniques (MeSH)</term>
<term>Pédiatrie (MeSH)</term>
<term>Soins de réanimation (méthodes)</term>
<term>Soins de réanimation (statistiques et données numériques)</term>
<term>Sédation consciente (méthodes)</term>
<term>Sédation consciente (statistiques et données numériques)</term>
<term>Types de pratiques des médecins (statistiques et données numériques)</term>
<term>Unités de soins intensifs pédiatriques (MeSH)</term>
<term>Utilisation médicament (statistiques et données numériques)</term>
</keywords>
<keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Analgesia</term>
<term>Conscious Sedation</term>
<term>Critical Care</term>
</keywords>
<keywords scheme="MESH" qualifier="méthodes" xml:lang="fr"><term>Analgésie</term>
<term>Soins de réanimation</term>
<term>Sédation consciente</term>
</keywords>
<keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Analgesia</term>
<term>Conscious Sedation</term>
<term>Critical Care</term>
<term>Drug Utilization</term>
<term>Healthcare Disparities</term>
<term>Practice Patterns, Physicians'</term>
</keywords>
<keywords scheme="MESH" qualifier="statistiques et données numériques" xml:lang="fr"><term>Analgésie</term>
<term>Disparités d'accès aux soins</term>
<term>Soins de réanimation</term>
<term>Sédation consciente</term>
<term>Types de pratiques des médecins</term>
<term>Utilisation médicament</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Canada</term>
<term>Child</term>
<term>Clinical Protocols</term>
<term>Health Care Surveys</term>
<term>Humans</term>
<term>Intensive Care Units, Pediatric</term>
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</keywords>
<keywords scheme="MESH" xml:lang="fr"><term>Canada</term>
<term>Enfant</term>
<term>Enquêtes sur les soins de santé</term>
<term>Humains</term>
<term>Protocoles cliniques</term>
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<front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b>
</p>
<p>Despite the fact that almost all critically ill children experience some degree of pain or anxiety, there is a lack of high-quality evidence to inform preferred approaches to sedation, analgesia, and comfort measures in this environment. We conducted this survey to better understand current comfort and sedation practices among Canadian pediatric intensivists.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>METHODS</b>
</p>
<p>The survey was conducted after a literature review and initial focus groups. The survey was then pretested and validated. The final survey was distributed by email to 134 intensivists from 17 PICUs across Canada using the Research Electronic Data Capture system.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>RESULTS</b>
</p>
<p>The response rate was 73% (98/134). The most commonly used sedation scores are Face, Legs, Activity, Cry, and Consolability (42%) and COMFORT (41%). Withdrawal scores are commonly used (65%). In contrast, delirium scores are used by only 16% of the respondents. Only 36% of respondents have routinely used sedation protocols. The majority (66%) do not use noise reduction methods, whereas only 23% of respondents have a protocol to promote day/night cycles. Comfort measures including music, swaddling, soother, television, and sucrose solutions are frequently used. The drugs most commonly used to provide analgesia are morphine and acetaminophen. Midazolam and chloral hydrate were the most frequent sedatives.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>CONCLUSION</b>
</p>
<p>Our survey demonstrates great variation in practice in the management of pain and anxiety in Canadian PICUs. Standardized strategies for sedation, delirium and withdrawal, and sleep promotion are lacking. There is a need for research in this field and the development of evidence-based, pediatric sedation and analgesia guidelines.</p>
</div>
</front>
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<Abstract><AbstractText Label="BACKGROUND">Despite the fact that almost all critically ill children experience some degree of pain or anxiety, there is a lack of high-quality evidence to inform preferred approaches to sedation, analgesia, and comfort measures in this environment. We conducted this survey to better understand current comfort and sedation practices among Canadian pediatric intensivists.</AbstractText>
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<AbstractText Label="RESULTS">The response rate was 73% (98/134). The most commonly used sedation scores are Face, Legs, Activity, Cry, and Consolability (42%) and COMFORT (41%). Withdrawal scores are commonly used (65%). In contrast, delirium scores are used by only 16% of the respondents. Only 36% of respondents have routinely used sedation protocols. The majority (66%) do not use noise reduction methods, whereas only 23% of respondents have a protocol to promote day/night cycles. Comfort measures including music, swaddling, soother, television, and sucrose solutions are frequently used. The drugs most commonly used to provide analgesia are morphine and acetaminophen. Midazolam and chloral hydrate were the most frequent sedatives.</AbstractText>
<AbstractText Label="CONCLUSION">Our survey demonstrates great variation in practice in the management of pain and anxiety in Canadian PICUs. Standardized strategies for sedation, delirium and withdrawal, and sleep promotion are lacking. There is a need for research in this field and the development of evidence-based, pediatric sedation and analgesia guidelines.</AbstractText>
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<ForeName>Gonzalo</ForeName>
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<Author ValidYN="Y"><LastName>Joffe</LastName>
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<InvestigatorList><Investigator ValidYN="Y"><LastName>Ryerson</LastName>
<ForeName>Lindsay</ForeName>
<Initials>L</Initials>
</Investigator>
<Investigator ValidYN="Y"><LastName>Chan</LastName>
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<Investigator ValidYN="Y"><LastName>Zorzela</LastName>
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<name sortKey="Duncan, Shannon" sort="Duncan, Shannon" uniqKey="Duncan S" first="Shannon" last="Duncan">Shannon Duncan</name>
<name sortKey="Hartling, Lisa" sort="Hartling, Lisa" uniqKey="Hartling L" first="Lisa" last="Hartling">Lisa Hartling</name>
<name sortKey="Joffe, Ari R" sort="Joffe, Ari R" uniqKey="Joffe A" first="Ari R" last="Joffe">Ari R. Joffe</name>
<name sortKey="Jou, Hsing" sort="Jou, Hsing" uniqKey="Jou H" first="Hsing" last="Jou">Hsing Jou</name>
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<name sortKey="Tawfik, Gerda" sort="Tawfik, Gerda" uniqKey="Tawfik G" first="Gerda" last="Tawfik">Gerda Tawfik</name>
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<country name="Canada"><noRegion><name sortKey="Garcia Guerra, Gonzalo" sort="Garcia Guerra, Gonzalo" uniqKey="Garcia Guerra G" first="Gonzalo" last="Garcia Guerra">Gonzalo Garcia Guerra</name>
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	Serveur d'exploration Santé et pratique musicale
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Serveur d'exploration Santé et pratique musicale

Survey of Sedation and Analgesia Practice Among Canadian Pediatric Critical Care Physicians.

Survey of Sedation and Analgesia Practice Among Canadian Pediatric Critical Care Physicians.

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