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Assessment of continuous pain in newborns admitted to NICUs in 18 European countries
Departments of Pediatrics, Anesthesiology, Perioperative & Pain Medicine, Stanford University School of Medicine, Stanford CA, USA.
Örebro universitet, Institutionen för hälsovetenskaper. (PEARL - Pain in Early Life)ORCID-id: 0000-0002-5996-2584
Department of Health Sciences, University of Leicester, Leicester, United Kingdom .
Department of Neonatology, Complexo Hospitalario Universitario de A Coruña, Coruña, Spain.
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2017 (Engelska)Ingår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 106, nr 8, s. 1248-1259Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Aim: Continuous pain occurs routinely, even after invasive procedures, or inflammation and surgery, but clinical practices associated with assessments of continuous pain remain unknown.

Methods: A prospective cohort study in 243 Neonatal Intensive Care Units (NICUs) from 18 European countries recorded frequency of pain assessments, use of mechanical ventilation, sedation, analgesia, or neuromuscular blockade for each neonate upto 28 days after NICU admission.

Results: Only 2113/6648 (31·8%) of neonates received assessments of continuous pain, occurring variably among tracheal ventilation (TrV, 46·0%), noninvasive ventilation (NiV, 35·0%), and no ventilation (NoV, 20·1%) groups (p<0·001). Daily assessments for continuous pain occurred in only 10·4% of all neonates (TrV: 14·0%, NiV: 10·7%, NoV: 7·6%; p<0·001). More frequent assessments of continuous pain occurred in NICUs with pain guidelines, nursing champions, and surgical admissions prompted (all p<0·01), and for newborns <32 weeks gestational age, those requiring ventilation, or opioids, sedatives-hypnotics, general anesthetics (O-SH-GA) (all p<0·001), or surgery (p=0·028). Use of O-SH-GA drugs increased the odds for pain assessment in the TrV (OR:1·60, p<0·001) and NiV groups (OR:1·40, p<0·001).

Conclusion: Assessments of continuous pain occurred in less than one-third of NICU admissions, and daily in only 10% of neonates. NICU clinical practices should consider including routine assessments of continuous pain in newborns.

Ort, förlag, år, upplaga, sidor
John Wiley & Sons, 2017. Vol. 106, nr 8, s. 1248-1259
Nyckelord [en]
Clinical practices; Infant-newborn; Infant-premature; Neonatal intensive care units; Suffering
Nationell ämneskategori
Pediatrik
Forskningsämne
Omvårdnadsforskning med medicinsk inriktning
Identifikatorer
URN: urn:nbn:se:oru:diva-56956DOI: 10.1111/apa.13810ISI: 000405233800009PubMedID: 28257153Scopus ID: 2-s2.0-85018571079OAI: oai:DiVA.org:oru-56956DiVA, id: diva2:1086930
Projekt
NeoopiodEUROPAIN - EUROpean-Pain-Audit-In-Neonates
Forskningsfinansiär
EU, FP7, Sjunde ramprogrammet, 223767Tillgänglig från: 2017-04-04 Skapad: 2017-04-04 Senast uppdaterad: 2017-10-22Bibliografiskt granskad

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Eriksson, Mats

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