2022 Society of Critical Care Medicine Clinical Practice Guidelines on Prevention and Management of Pain, Agitation, Neuromuscular Blockade, and Delirium in Critically Ill Pediatric Patients With Consideration of the ICU Environment and Early Mobility.
Journal
Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
ISSN: 1529-7535
Titre abrégé: Pediatr Crit Care Med
Pays: United States
ID NLM: 100954653
Informations de publication
Date de publication:
01 02 2022
01 02 2022
Historique:
entrez:
4
2
2022
pubmed:
5
2
2022
medline:
21
4
2022
Statut:
ppublish
Résumé
A guideline that both evaluates current practice and provides recommendations to address sedation, pain, and delirium management with regard for neuromuscular blockade and withdrawal is not currently available. To develop comprehensive clinical practice guidelines for critically ill infants and children, with specific attention to seven domains of care including pain, sedation/agitation, iatrogenic withdrawal, neuromuscular blockade, delirium, PICU environment, and early mobility. The Society of Critical Care Medicine Pediatric Pain, Agitation, Neuromuscular Blockade, and Delirium in critically ill pediatric patients with consideration of the PICU Environment and Early Mobility Guideline Taskforce was comprised of 29 national experts who collaborated from 2009 to 2021 via teleconference and/or e-mail at least monthly for planning, literature review, and guideline development, revision, and approval. The full taskforce gathered annually in-person during the Society of Critical Care Medicine Congress for progress reports and further strategizing with the final face-to-face meeting occurring in February 2020. Throughout this process, the Society of Critical Care Medicine standard operating procedures Manual for Guidelines development was adhered to. Taskforce content experts separated into subgroups addressing pain/analgesia, sedation, tolerance/iatrogenic withdrawal, neuromuscular blockade, delirium, PICU environment (family presence and sleep hygiene), and early mobility. Subgroups created descriptive and actionable Population, Intervention, Comparison, and Outcome questions. An experienced medical information specialist developed search strategies to identify relevant literature between January 1990 and January 2020. Subgroups reviewed literature, determined quality of evidence, and formulated recommendations classified as "strong" with "we recommend" or "conditional" with "we suggest." Good practice statements were used when indirect evidence supported benefit with no or minimal risk. Evidence gaps were noted. Initial recommendations were reviewed by each subgroup and revised as deemed necessary prior to being disseminated for voting by the full taskforce. Individuals who had an overt or potential conflict of interest abstained from relevant votes. Expert opinion alone was not used in substitution for a lack of evidence. The Pediatric Pain, Agitation, Neuromuscular Blockade, and Delirium in critically ill pediatric patients with consideration of the PICU Environment and Early Mobility taskforce issued 44 recommendations (14 strong and 30 conditional) and five good practice statements. The current guidelines represent a comprehensive list of practical clinical recommendations for the assessment, prevention, and management of key aspects for the comprehensive critical care of infants and children. Main areas of focus included 1) need for the routine monitoring of pain, agitation, withdrawal, and delirium using validated tools, 2) enhanced use of protocolized sedation and analgesia, and 3) recognition of the importance of nonpharmacologic interventions for enhancing patient comfort and comprehensive care provision.
Identifiants
pubmed: 35119438
doi: 10.1097/PCC.0000000000002873
pii: 00130478-202202000-00015
doi:
Types de publication
Journal Article
Practice Guideline
Langues
eng
Sous-ensembles de citation
IM
Pagination
e74-e110Commentaires et corrections
Type : CommentIn
Informations de copyright
Copyright © 2022 by the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies.
Déclaration de conflit d'intérêts
Drs. Smith and Berkenbosch were responsible for the adjudication of any conflicts of interest for this guideline. The following relevant disclosures were provided for consideration. Dr. Srinivasan authored “Conversion from prolonged intravenous fentanyl infusion to enteral methadone in critically ill children,” World Journal of Clinical Pediatrics (May 2017). Dr. Almgren authored “Pharmacological Strategies for Decreasing Opioid Therapy and Management of Side Effects From Chronic Use”, Children (2018) and “Multidisciplinary Pain Management for Pediatric Patients with Acute and Chronic Pain: A Foundational Treatment Approach When Prescribing Opioids,” Children (2019). Dr. Grant was a lead author for the Randomized Evaluation of Sedation Titration for Respiratory Failure (RESTORE) Study Investigators (2016) and for “Dexmedetomidine Use in Critically-Ill Children with Acute Respiratory Failure,” Pediatric Critical Care Medicine. Dr. deAlmeida was a contributing author on “Delirium in Critically Ill Children: An International Point Prevalence Study,” Critical Care Medicine (2017). Dr. Simone is a lead author for “Analgesia, Sedation, Paralytics, and Opioid Syndrome (2021); Pediatric Acute Care. A Guide for Interprofessional Practice, second Edition (2019); Delirium and Pharmacologic Treatment in Critically Ill Children: A Retrospective Matched Cohort Study,” Journal of Pediatric Pharmacologic and Therapeutics (2017). “Implementation of an ICU Bundle: An Interprofessional Quality Improvement Project to Enhance Delirium Management and Monitor Delirium Prevalence in a Single PICU,” Pediatric Critical Care Medicine (2017). Dr. Su was a lead author for “Pharmacokinetics of Dexmedetomidine in Infants and Children After Orthotopic Liver Transplantation,” Anesthesia Analog (2018). Dr. Traube was a lead author on “Detection and Management of Delirium in the Neonatal Unit: A Case Series,” Pediatrics (2016); “Prospective Study to Establish the German version of the CAPD for the Assessment of Delirium in Children Undergoing Intensive Care” (German), Monatsschrift Kinderheilkunde (2016); “Cost Associated With Pediatric Delirium in the ICU,” Critical Care Medicine (2016); “Validity of the Richmond Agitation-Sedation Scale (RASS) in Critically Ill Children,” Journal of Intensive Care (2016); “Sedation, Analgesia, and Paralysis During Mechanical Ventilation of Premature Infants,”(2017), “Patterns of Postoperative Delirium in Children,” Pediatric Critical Care Medicine (2017); “Delirium in Children After Cardiac Bypass Surgery,” Pediatric Critical Care Medicine (2017); “Delirium in Critically Ill Children: An International Point Prevalence Study,”Critical Care Medicine (2017); “Delirium and Mortality in Critically Ill Children: Epidemiology and Outcomes of Pediatric Delirium,” Critical Care Medicine (2017); “Iatrogenic Withdrawal Syndrome or Undiagnosed Delirium?,” Critical Care Medicine (2017); “‘The Times They Are A-Changin’: Universal Delirium Screening in Pediatric Critical Care,” Pediatric Critical Care Medicine (2017); “Quality Improvement Initiative to Reduce Pediatric Intensive Care Unit Noise Pollution With the Use of a Pediatric Delirium Bundle,” Journal of Intensive Care Medicine (2017); “Delirium in Pediatric Critical Care,” Pediatric Clinics of North America (2017); “Delirium in the Pediatric Cardiac Extracorporeal Membrane Oxygenation Patient Population: A Case Series,” Pediatric Critical Care Medicine (2017); “Delirium in Hospitalized Children with Cancer: Incidence and Associated Risk Factors,” The Journal of Pediatrics (2017); “Provider Beliefs Regarding Early Mobilization in the Pediatric Intensive Care Unit,” Journal of Pediatric Nursing (2018); “Identify Delirium, Then Investigate for Underlying Etiology,” Pediatric Critical Care Medicine (2018); “Consensus Report by PALISI and PBMTC Joint Working Committees, Supportive Care Guidelines for Management of VOD in Children and Adolescents; Part 3: Focus on Cardio-Respiratory Dysfunction, Infections, Liver Dysfunction and Delirium,” Biology of Blood and Marrow Transplantation (2018); “Delirium is a Common and Early Finding in Patients in the Pediatric Cardiac Intensive Care Unit,” The Journal of Pediatrics (2018); “Delirium Upon Presentation to the Pediatric Emergency Department: A Case Series,” Pediatric Emergency Care (2018); “Benzodiazepines and Development of Delirium in Critically Ill Children: Estimating the Causal Effect,” Critical Care Medicine (2018); “Association Between Transfusion of RBCs and Subsequent Development of Delirium in Critically Ill Children,” Pediatric Critical Care Medicine (2018); “All Delirium May Not Be Created Equal: Consideration of Differential Effects of Delirium Based Upon Underlying Etiology,” Pediatric Critical Care Medicine (2018); “Risk Factors for the Development of Postoperative Delirium in Pediatric Intensive Care Patients,” Pediatric Critical Care Medicine (2018); “Management Guidelines For Paediatric Patients Receiving Chimeric Antigen Receptor T Cell Therapy,” Nature Reviews Clinical Oncology (2019); and “A Systematic Approach to Family Engagement: Feasibility Pilot of a Pediatric Delirium Management And Prevention Toolkit,” Palliative and Supportive Care (2019). Stacey Williams was lead author for “The Preschool Confusion Assessment Method for the ICU: Valid and Reliable Delirium Monitoring for Critically Ill Infants and Children,” Critical Care Medicine(2016). The remaining authors have disclosed that they do not have any potential conflicts of interest. Taskforce content experts separated into subgroups addressing pain/analgesia, sedation, tolerance/iatrogenic withdrawal, neuromuscular blockade, delirium, PICU environment (family presence and sleep hygiene), and early mobility. Subgroups created descriptive and actionable Population, Intervention, Comparison, and Outcome questions. An experienced medical information specialist developed search strategies to identify relevant literature between January 1990 and January 2020. Subgroups reviewed literature, determined quality of evidence, and formulated recommendations classified as “strong” with “we recommend” or “conditional” with “we suggest.” Good practice statements were used when indirect evidence supported benefit with no or minimal risk. Evidence gaps were noted. Initial recommendations were reviewed by each subgroup and revised as deemed necessary prior to being disseminated for voting by the full taskforce. Individuals who had an overt or potential conflict of interest abstained from relevant votes. Expert opinion alone was not used in substitution for a lack of evidence.
Références
Barr J, Fraser GL, Puntillo K, et al.; American College of Critical Care Medicine: Clinical practice guidelines for the management of pain, agitation, and delirium in adult patients in the intensive care unit. Crit Care Med 2013; 41:263–306
Devlin JW, Skrobik Y, Gélinas C, et al.: Clinical practice guidelines for the prevention and management of pain, agitation/sedation, delirium, immobility, and sleep disruption in adult patients in the ICU. Crit Care Med 2018; 46:e825–e873
Twite MD, Rashid A, Zuk J, et al.: Sedation, analgesia, and neuromuscular blockade in the pediatric intensive care unit: Survey of fellowship training programs. Pediatr Crit Care Med 2004; 5:521–532
Long D, Horn D, Keogh S: A survey of sedation assessment and management in Australian and New Zealand paediatric intensive care patients requiring prolonged mechanical ventilation. Aust Crit Care 2005; 18:152–157
Jenkins IA, Playfor SD, Bevan C, et al.: Current United Kingdom sedation practice in pediatric intensive care. Paediatr Anaesth 2007; 17:675–683
Harris J, Ramelet AS, van Dijk M, et al.: 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 2016; 42:972–986
Playfor S, Jenkins I, Boyles C, et al.; United Kingdom Paediatric Intensive Care Society Sedation; Analgesia and Neuromuscular Blockade Working Group: Consensus guidelines on sedation and analgesia in critically ill children. Intensive Care Med 2006; 32:1125–1136
Heneghan C: Bmj evidence-based medicine in 2018. BMJ Evid-Based Med 2019; 24:43–44
Guyatt G, Gutterman D, Baumann MH, et al.: Grading strength of recommendations and quality of evidence in clinical guidelines: Report from an American College of Chest Physicians Task Force. Chest 2006; 129:174–181
Guyatt GH, Oxman AD, Kunz R, et al.: Going from evidence to recommendations. BMJ 2008; 336:1049–1051
Guyatt GH, Oxman AD, Kunz R, et al.; GRADE Working Group: What is “quality of evidence” and why is it important to clinicians? BMJ 2008; 336:995–998
Guyatt GH, Oxman AD, Vist GE, et al.: Grade: An emerging consensus on rating quality of evidence and strength of recommendations. BMJ 2008; 336:924–926
Kozlowski LJ, Kost-Byerly S, Colantuoni E, et al.: Pain prevalence, intensity, assessment and management in a hospitalized pediatric population. Pain Manag Nurs 2014; 15:22–35
Groenewald CB, Rabbitts JA, Schroeder DR, et al.: Prevalence of moderate-severe pain in hospitalized children. Paediatr Anaesth 2012; 22:661–668
Cummings EA, Reid GJ, Finley AG, et al.: Prevalence and source of pain in pediatric inpatients. Pain 1996; 68:25–31
Aranda JV, Carlo W, Hummel P, et al.: Analgesia and sedation during mechanical ventilation in neonates. Clin Ther 2005; 27:877–899
Cignacco E, Hamers JP, van Lingen RA, et al.: Pain relief in ventilated preterms during endotracheal suctioning: A randomized controlled trial. Swiss Med Wkly 2008; 138:635–645
Kortesluoma RL, Nikkonen M, Serlo W: “You just have to make the pain go away”–children’s experiences of pain management. Pain Manag Nurs 2008; 9:143–9, 149.e1
Sönmez Düzkaya D, Kuğuoğlu S: Assessment of pain during endotracheal suction in the pediatric intensive care unit. Pain Manag Nurs 2015; 16:11–19
Baarslag MA, Jhingoer S, Ista E, et al.: How often do we perform painful and stressful procedures in the paediatric intensive care unit? A prospective observational study. Aust Crit Care 2019; 32:4–10
Aitken LM, Elliott R, Mitchell M, et al.: Sleep assessment by patients and nurses in the intensive care: An exploratory descriptive study. Aust Crit Care 2017; 30:59–66
American Academy of Pediatrics. Committee on Psychosocial Aspects of Child and Family Health; Task Force on Pain in Infants, Children, and Adolescents: The assessment and management of acute pain in infants, children, and adolescents. Pediatrics 2001; 108:793–797
Armour AD, Khoury JC, Kagan RJ, et al.: Clinical assessment of sleep among pediatric burn patients does not correlate with polysomnography. J Burn Care Res 2011; 32:529–534
Hermann C, Hohmeister J, Demirakça S, et al.: Long-term alteration of pain sensitivity in school-aged children with early pain experiences. Pain 2006; 125:278–285
Ismail A: The challenges of providing effective pain management for children in the pediatric intensive care unit. Pain Manag Nurs 2016; 17:372–383
Nimmo WS, Duthie DJ: Pain relief after surgery. Anaesth Intensive Care 1987; 15:68–71
Jones SM, Fiser DH, Livingston RL: Behavioral changes in pediatric intensive care units. Am J Dis Child 1992; 146:375–379
Melnyk BM, Alpert-Gillis L, Feinstein NF, et al.: Creating opportunities for parent empowerment: Program effects on the mental health/coping outcomes of critically ill young children and their mothers. Pediatrics 2004; 113:e597–e607
Czarnecki ML, Simon K, Thompson JJ, et al.: Barriers to pediatric pain management: A nursing perspective. Pain Manag Nurs 2011; 12:154–162
LaFond CM, Van Hulle Vincent C, Oosterhouse K, et al.: Nurses’ beliefs regarding pain in critically ill children: A mixed-methods study. J Pediatr Nurs 2016; 31:691–700
Twycross A: Achieving consensus about pain content for child branch curricula. J Adv Nurs 2001; 34:51–60
Van Hulle Vincent C: Nurses’ knowledge, attitudes, and practices: Regarding children’s pain. MCN Am J Matern Child Nurs 2005; 30:177–183
Kudchadkar SR, Yaster M, Punjabi NM: Sedation, sleep promotion, and delirium screening practices in the care of mechanically ventilated children: a wake-up call for the pediatric critical care community. Crit Care Med 2014; 42:1592–1600
Ismail A, Forgeron P, Polomeno V, et al.: Pain management interventions in the paediatric intensive care unit: A scoping review. Intensive Crit Care Nurs 2019; 54:96–105
van der Heijden MJ, Oliai Araghi S, van Dijk M, et al.: The effects of perioperative music interventions in pediatric surgery: A systematic review and meta-analysis of randomized controlled trials. PLoS One 2015; 10:e0133608
Hoffman HG, Rodriguez RA, Gonzalez M, et al.: Immersive virtual reality as an adjunctive non-opioid analgesic for pre-dominantly Latin American children with large severe burn wounds during burn wound cleaning in the intensive care unit: A pilot study. Front Hum Neurosci 2019; 13:262
Beltramini A, Milojevic K, Pateron D: Pain assessment in newborns, infants, and children. Pediatr Ann 2017; 46:e387–e395
Huguet A, Stinson JN, McGrath PJ: Measurement of self-reported pain intensity in children and adolescents. J Psychosom Res 2010; 68:329–336
Stinson JN, Kavanagh T, Yamada J, et al.: Systematic review of the psychometric properties, interpretability and feasibility of self-report pain intensity measures for use in clinical trials in children and adolescents. Pain 2006; 125:143–157
McGrath PA, Seifert CE, Speechley KN, et al.: A new analogue scale for assessing children’s pain: An initial validation study. Pain 1996; 64:435–443
Szyfelbein SK, Osgood PF, Carr DB: The assessment of pain and plasma beta-endorphin immunoactivity in burned children. Pain 1985; 22:173–182
Beyer JE, Aradine CR: Content validity of an instrument to measure young children’s perceptions of the intensity of their pain. J Pediatr Nurs 1986; 1:386–395
Bieri D, Reeve RA, Champion DG, et al.: The faces pain scale for the self-assessment of the severity of pain experienced by children: Development, initial validation, and preliminary investigation for ratio scale properties. Pain 1990; 41:139–150
Rotondi AJ, Chelluri L, Sirio C, et al.: Patients’ recollections of stressful experiences while receiving prolonged mechanical ventilation in an intensive care unit. Crit Care Med 2002; 30:746–752
Franck LS, Ridout D, Howard R, et al.: A comparison of pain measures in newborn infants after cardiac surgery. Pain 2011; 152:1758–1765
Dantas LV, Dantas TS, Santana Filho VJ, et al.: Pain assessment during blood collection from sedated and mechanically ventilated children. Rev Bras Ter Intensiva 2016; 28:49–54
Välitalo PAJ, van Dijk M, Krekels EHJ, et al.: Pain and distress caused by endotracheal suctioning in neonates is better quantified by behavioural than physiological items: A comparison based on item response theory modelling. Pain 2016; 157:1611–1617
Büttner W, Finke W: Analysis of behavioural and physiological parameters for the assessment of postoperative analgesic demand in newborns, infants and young children: A comprehensive report on seven consecutive studies. Paediatr Anaesth 2000; 10:303–318
Dorfman TL, Sumamo Schellenberg E, Rempel GR, et al.: An evaluation of instruments for scoring physiological and behavioral cues of pain, non-pain related distress, and adequacy of analgesia and sedation in pediatric mechanically ventilated patients: A systematic review. Int J Nurs Stud 2014; 51:654–676
Ahlers SJ, van Gulik L, van der Veen AM, et al.: Comparison of different pain scoring systems in critically ill patients in a general ICU. Crit Care 2008; 12:R15
Manworren RC, Hynan LS: Clinical validation of FLACC: Preverbal patient pain scale. Pediatr Nurs 2003; 29:140–146
Voepel-Lewis T, Zanotti J, Dammeyer JA, et al.: Reliability and validity of the face, legs, activity, cry, consolability behavioral tool in assessing acute pain in critically ill patients. Am J Crit Care 2010; 19:55–61; quiz 62
Malviya S, Voepel-Lewis T, Burke C, et al.: The revised FLACC observational pain tool: Improved reliability and validity for pain assessment in children with cognitive impairment. Paediatr Anaesth 2006; 16:258–265
Ambuel B, Hamlett KW, Marx CM, et al.: Assessing distress in pediatric intensive care environments: The COMFORT scale. J Pediatr Psychol 1992; 17:95–109
van Dijk M, de Boer JB, Koot HM, et al.: The reliability and validity of the COMFORT scale as a postoperative pain instrument in 0 to 3-year-old infants. Pain 2000; 84:367–377
Ista E, van Dijk M, Tibboel D, et al.: Assessment of sedation levels in pediatric intensive care patients can be improved by using the COMFORT “behavior” scale. Pediatr Crit Care Med 2005; 6:58–63
Boerner KE, Birnie KA, Caes L, et al.: Sex differences in experimental pain among healthy children: A systematic review and meta-analysis. Pain 2014; 155:983–993
Puntillo KA, White C, Morris AB, et al.: Patients’ perceptions and responses to procedural pain: Results from Thunder Project II. Am J Crit Care 2001; 10:238–251
Smith HA, Berutti T, Brink E, et al.: Pediatric critical care perceptions on analgesia, sedation, and delirium. Semin Respir Crit Care Med 2013; 34:244–261
Johnson PN: Pain and sedation. In : Advanced Pediatric Therapeutics. Eiland LTT, (Ed). First Edition. Memphis, TN, Pediatric Pharmacy Advocacy Group, 2015, pp 433
Garcia Guerra G, Joffe AR, Cave D, et al.; Sedation Withdrawal and Analgesia Team, and the Canadian Critical Care Trials Group: Survey of sedation and analgesia practice among Canadian pediatric critical care physicians. Pediatr Crit Care Med 2016; 17:823–830
Playfor SD, Thomas DA, Choonara I: Sedation and neuromuscular blockade in paediatric intensive care: A review of current practice in the UK. Paediatr Anaesth 2003; 13:147–151
Welzing L, Oberthuer A, Junghaenel S, et al.: Remifentanil/midazolam versus fentanyl/midazolam for analgesia and sedation of mechanically ventilated neonates and young infants: A randomized controlled trial. Intensive Care Med 2012; 38:1017–1024
Reiter PD, Ng J, Dobyns EL: Continuous hydromorphone for pain and sedation in mechanically ventilated infants and children. J Opioid Manag 2012; 8:99–104
Akinci SB, Kanbak M, Guler A, et al.: Remifentanil versus fentanyl for short-term analgesia-based sedation in mechanically ventilated postoperative children. Paediatr Anaesth 2005; 15:870–878
Chiaretti A, Pietrini D: Safety and efficacy of remifentanil infusion in craniosynostosis repair in infants. Pediatr Neurosurg 2002; 36:55–56
Alencar AJ, Sanudo A, Sampaio VM, et al.: Efficacy of tramadol versus fentanyl for postoperative analgesia in neonates. Arch Dis Child Fetal Neonatal Ed 2012; 97:F24–F29
Hungerford JL, O’Brien N, Moore-Clingenpeel M, et al.: Remifentanil for sedation of children with traumatic brain injury. J Intensive Care Med 2019; 34:557–562
Curley MA, Wypij D, Watson RS, et al.: Protocolized sedation vs usual care in pediatric patients mechanically ventilated for acute respiratory failure: A randomized clinical trial. JAMA 2015; 313:379–389
Smith MT, Watt JA, Cramond T: Morphine-3-glucuronide–A potent antagonist of morphine analgesia. Life Sci 1990; 47:579–585
Pasternak GW, Bodnar RJ, Clark JA, et al.: Morphine-6-glucuronide, a potent mu agonist. Life Sci 1987; 41:2845–2849
Inoue M, Caldarone CA, Frndova H, et al.: Safety and efficacy of ketorolac in children after cardiac surgery. Intensive Care Med 2009; 35:1584–1592
Sutters KA, Shaw BA, Gerardi JA, et al.: Comparison of morphine patient-controlled analgesia with and without ketorolac for postoperative analgesia in pediatric orthopedic surgery. Am J Orthop (Belle Mead NJ) 1999; 28:351–358
Munro HM, Walton SR, Malviya S, et al.: Low-dose ketorolac improves analgesia and reduces morphine requirements following posterior spinal fusion in adolescents. Can J Anaesth 2002; 49:461–466
Nour C, Ratsiu J, Singh N, et al.: Analgesic effectiveness of acetaminophen for primary cleft palate repair in young children: A randomized placebo controlled trial. Paediatr Anaesth 2014; 24:574–581
Dawkins TN, Barclay CA, Gardiner RL, et al.: Safety of intravenous use of ketorolac in infants following cardiothoracic surgery. Cardiol Young 2009; 19:105–108
Wong I, St John-Green C, Walker SM: Opioid-sparing effects of perioperative paracetamol and nonsteroidal anti-inflammatory drugs (NSAIDs) in children. Paediatr Anaesth 2013; 23:475–495
Zhu A, Benzon HA, Anderson TA: Evidence for the efficacy of systemic opioid-sparing analgesics in pediatric surgical populations: A systematic review. Anesth Analg 2017; 125:1569–1587
Ceelie I, de Wildt SN, van Dijk M, et al.: Effect of intravenous paracetamol on postoperative morphine requirements in neonates and infants undergoing major noncardiac surgery: A randomized controlled trial. JAMA 2013; 309:149–154
Olbrecht VA, Ding L, Spruance K, et al.: Intravenous acetaminophen reduces length of stay via mediation of postoperative opioid consumption after posterior spinal fusion in a pediatric cohort. Clin J Pain 2018; 34:593–599
Drahota A, Ward D, Mackenzie H, et al.: Sensory environment on health-related outcomes of hospital patients. Cochrane Database Syst Rev 2012; 2021:CD005315
Alay B, Esenay FI: The clinical effect of classical music and lullaby on term babies in neonatal intensive care unit: A randomised controlled trial. J Pak Med Assoc 2019; 69:459–463
Mahmud S, Shah SA, Khattak SZ: Neonatal pain and preventive strategies: An experience in a tertiary care unit. J Ayub Med Coll Abbottabad 2017; 29:42–44
O’Toole A, Francis K, Pugsley L: Does music positively impact preterm infant outcomes? Adv Neonatal Care 2017; 17:192–202
Ranger A, Helmert E, Bott TS, et al.: Physiological and emotional effects of pentatonic live music played for preterm neonates and their mothers in the Newborn Intensive Care Unit: A randomized controlled trial. Complement Ther Med 2018; 41:240–246
Tekgündüz KŞ, Polat S, Gürol A, et al.: Oral glucose and listening to lullaby to decrease pain in preterm infants supported with NCPAP: A randomized controlled trial. Pain Manag Nurs 2019; 20:54–61
Nilsson S, Kokinsky E, Nilsson U, et al.: School-aged children’s experiences of postoperative music medicine on pain, distress, and anxiety. Paediatr Anaesth 2009; 19:1184–1190
Bergomi P, Chieppi M, Maini A, et al.: Nonpharmacological techniques to reduce pain in preterm infants who receive heel-lance procedure: A randomized controlled trial. Res Theory Nurs Pract 2014; 28:335–348
Butt ML, Kisilevsky BS: Music modulates behaviour of premature infants following heel lance. Can J Nurs Res 2000; 31:17–39
Abd-Elshafy SK, Khalaf GS, Abo-Kerisha MZ, et al.: Not all sounds have negative effects on children undergoing cardiac surgery. J Cardiothorac Vasc Anesth 2015; 29:1277–1284
Disher T, Cameron C, Mitra S, et al.: Pain-relieving interventions for retinopathy of prematurity: A meta-analysis. Pediatrics 2018; 142:e20180401
Kristoffersen L, Malahleha M, Duze Z, et al.: Randomised controlled trial showed that neonates received better pain relief from a higher dose of sucrose during venepuncture. Acta Paediatr 2018; 107:2071–2078
Liu Y, Huang X, Luo B, et al.: Effects of combined oral sucrose and nonnutritive sucking (nns) on procedural pain of NICU newborns, 2001 to 2016: A prisma-compliant systematic review and meta-analysis. Medicine (Baltimore) 2017; 96:e6108
Matar EM, Arabiat DH, Foster MJ: Oral glucose efficacy on neonate’s pain responses at the NICU: A quasi experimental trial of two clinical procedures. Appl Nurs Res 2016; 32:36–40
Sethi A, Sankar MJ, Kulkarni S, et al.: Low dose fentanyl infusion versus 24% oral sucrose for pain management during laser treatment for retinopathy of prematurity-an open label randomized clinical trial. Eur J Pediatr 2020; 179:285–292
Stevens B, Yamada J, Campbell-Yeo M, et al.: The minimally effective dose of sucrose for procedural pain relief in neonates: A randomized controlled trial. BMC Pediatr 2018; 18:85
Turan O, Akkoyun I, Ince DA, et al.: Effect of breast milk and sucrose on pain and perfusion index during examination for retinopathy of prematurity. J Matern Fetal Neonatal Med 2021; 34:1138–1142
Valeri BO, Gaspardo CM, Martinez FE, et al.: Effectiveness of sucrose used routinely for pain relief and neonatal clinical risk in preterm infants: A nonrandomized study. Clin J Pain 2018; 34:713–722
Liaw JJ, Yang L, Lee CM, et al.: Effects of combined use of non-nutritive sucking, oral sucrose, and facilitated tucking on infant behavioural states across heel-stick procedures: A prospective, randomised controlled trial. Int J Nurs Stud 2013; 50:883–894
Peng HF, Yin T, Yang L, et al.: Non-nutritive sucking, oral breast milk, and facilitated tucking relieve preterm infant pain during heel-stick procedures: A prospective, randomized controlled trial. Int J Nurs Stud 2018; 77:162–170
Leng HY, Zheng XL, Zhang XH, et al.: Combined non-pharmacological interventions for newborn pain relief in two degrees of pain procedures: A randomized clinical trial. Eur J Pain 2016; 20:989–997
Stevens B, Yamada J, Beyene J, et al.: Consistent management of repeated procedural pain with sucrose in preterm neonates: Is it effective and safe for repeated use over time? Clin J Pain 2005; 21:543–548
Meesters N, Simons S, van Rosmalen J, et al.: Waiting 2 minutes after sucrose administration-unnecessary? Arch Dis Child Fetal Neonatal Ed 2017; 102:F167–F169
Pandey M, Datta V, Rehan HS: Role of sucrose in reducing painful response to orogastric tube insertion in preterm neonates. Indian J Pediatr 2013; 80:476–482
Harrison D, Yamada J, Adams-Webber T, et al.: Sweet tasting solutions for reduction of needle-related procedural pain in children aged one to 16 years. Cochrane Database Syst Rev 2015; 2015:CD008408
Vet NJ, Ista E, de Wildt SN, et al.: Optimal sedation in pediatric intensive care patients: A systematic review. Intensive Care Med 2013; 39:1524–1534
Hartman ME, McCrory DC, Schulman SR: Efficacy of sedation regimens to facilitate mechanical ventilation in the pediatric intensive care unit: A systematic review. Pediatr Crit Care Med 2009; 10:246–255
Nasr VG, DiNardo JA: Sedation and analgesia in pediatric cardiac critical care. Pediatr Crit Care Med 2016; 17:S225–S231
Fitzgerald RK, Davis AT, Hanson SJ; National Association of Children’s Hospitals and Related Institution PICU Focus Group Investigators: Multicenter analysis of the factors associated with unplanned extubation in the PICU. Pediatr Crit Care Med 2015; 16:e217–e223
Lucas da Silva PS, Fonseca MCM: Incidence and risk factors for cardiovascular collapse after unplanned extubations in the pediatric ICU. Respir Care 2017; 62:896–903
Colville G, Kerry S, Pierce C: Children’s factual and delusional memories of intensive care. Am J Respir Crit Care Med 2008; 177:976–982
Randolph AG, Wypij D, Venkataraman ST, et al.; Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network: Effect of mechanical ventilator weaning protocols on respiratory outcomes in infants and children: A randomized controlled trial. JAMA 2002; 288:2561–2568
Traube C, Silver G, Gerber LM, et al.: Delirium and mortality in critically ill children: Epidemiology and outcomes of pediatric delirium. Crit Care Med 2017; 45:891–898
Fonsmark L, Rasmussen YH, Carl P: Occurrence of withdrawal in critically ill sedated children. Crit Care Med 1999; 27:196–199
Ista E, van Dijk M, Gamel C, et al.: Withdrawal symptoms in children after long-term administration of sedatives and/or analgesics: A literature review. “Assessment remains troublesome”. Intensive Care Med 2007; 33:1396–1406
Anand KJ, Willson DF, Berger J, et al.; Eunice Kennedy Shriver National Institute of Child Health and Human Development Collaborative Pediatric Critical Care Research Network: Tolerance and withdrawal from prolonged opioid use in critically ill children. Pediatrics 2010; 125:e1208–e1225
Johansson M, Kokinsky E: The COMFORT behavioural scale and the modified FLACC scale in paediatric intensive care. Nurs Crit Care 2009; 14:122–130
Boerlage AA, Ista E, Duivenvoorden HJ, et al.: The COMFORT behaviour scale detects clinically meaningful effects of analgesic and sedative treatment. Eur J Pain 2015; 19:473–479
Curley MA, Harris SK, Fraser KA, et al.: State behavioral scale: A sedation assessment instrument for infants and young children supported on mechanical ventilation. Pediatr Crit Care Med 2006; 7:107–114
Lebet R, Hayakawa J, Chamblee TB, et al.: Maintaining interrater agreement of core assessment instruments in a multisite randomized controlled clinical trial: The randomized evaluation of sedation titration for respiratory failure (RESTORE) trial. Nurs Res 2017; 66:323–329
Ge X, Zhang T, Zhou L: Psychometric analysis of subjective sedation scales used for critically ill paediatric patients. Nurs Crit Care 2018; 23:30–41
Kerson AG, DeMaria R, Mauer E, et al.: Validity of the Richmond Agitation-Sedation Scale (RASS) in critically ill children. J Intensive Care 2016; 4:65
Dreyfus L, Javouhey E, Denis A, et al.: Implementation and evaluation of a paediatric nurse-driven sedation protocol in a paediatric intensive care unit. Ann Intensive Care 2017; 7:36
Jin HS, Yum MS, Kim SL, et al.: The efficacy of the COMFORT scale in assessing optimal sedation in critically ill children requiring mechanical ventilation. J Korean Med Sci 2007; 22:693–697
Deeter KH, King MA, Ridling D, et al.: Successful implementation of a pediatric sedation protocol for mechanically ventilated patients. Crit Care Med 2011; 39:683–688
Gaillard-Le Roux B, Liet JM, Bourgoin P, et al.: Implementation of a nurse-driven sedation protocol in a PICU decreases daily doses of midazolam. Pediatr Crit Care Med 2017; 18:e9–e17
Kongkiattikul L, Dagenais M, Ruo N, et al.: The impact of a quality improvement project to standardize pain, agitation, and withdrawal assessments on the use of morphine and midazolam in the pediatric intensive care unit. Paediatr Anaesth 2019; 29:322–330
Larson GE, McKeever S: Nurse titrated analgesia and sedation in intensive care increases the frequency of comfort assessment and reduces midazolam use in paediatric patients following cardiac surgery. Aust Crit Care 2018; 31:31–36
Neunhoeffer F, Kumpf M, Renk H, et al.: Nurse-driven pediatric analgesia and sedation protocol reduces withdrawal symptoms in critically ill medical pediatric patients. Paediatr Anaesth 2015; 25:786–794
Neunhoeffer F, Seitz G, Schmidt A, et al.: Analgesia and sedation protocol for mechanically ventilated postsurgical children reduces benzodiazepines and withdrawal symptoms-but not in all patients. Eur J Pediatr Surg 2017; 27:255–262
Saelim K, Chavananon S, Ruangnapa K, et al.: Effectiveness of protocolized sedation utilizing the COMFORT-B scale in mechanically ventilated children in a pediatric intensive care unit. J Pediatr Intensive Care 2019; 8:156–163
Verlaat CW, Heesen GP, Vet NJ, et al.: Randomized controlled trial of daily interruption of sedatives in critically ill children. Paediatr Anaesth 2014; 24:151–156
Vet NJ, de Wildt SN, Verlaat CW, et al.: A randomized controlled trial of daily sedation interruption in critically ill children. Intensive Care Med 2016; 42:233–244
Gupta K, Gupta VK, Jayashree M, et al.: Randomized controlled trial of interrupted versus continuous sedative infusions in ventilated children. Pediatr Crit Care Med 2012; 13:131–135
da Silva PS, de Aguiar VE, Neto HM, et al.: Unplanned extubation in a paediatric intensive care unit: Impact of a quality improvement programme. Anaesthesia 2008; 63:1209–1216
Kaufman J, Rannie M, Kahn MG, et al.: An interdisciplinary initiative to reduce unplanned extubations in pediatric critical care units. Pediatrics 2012; 129:e1594–e1600
Popernack ML, Thomas NJ, Lucking SE: Decreasing unplanned extubations: Utilization of the Penn State Children’s Hospital sedation algorithm. Pediatr Crit Care Med 2004; 5:58–62
Rachman BR, Watson R, Woods N, et al.: Reducing unplanned extubations in a pediatric intensive care unit: A systematic approach. Int J Pediatr 2009; 2009:820495
Sadowski R, Dechert RE, Bandy KP, et al.: Continuous quality improvement: Reducing unplanned extubations in a pediatric intensive care unit. Pediatrics 2004; 114:628–632
Tripathi S, Nunez DJ, Katyal C, et al.: Plan to have no unplanned: A collaborative, hospital-based quality-improvement project to reduce the rate of unplanned extubations in the pediatric ICU. Respir Care 2015; 60:1105–1112
Aydogan MS, Korkmaz MF, Ozgül U, et al.: Pain, fentanyl consumption, and delirium in adolescents after scoliosis surgery: Dexmedetomidine vs midazolam. Paediatr Anaesth 2013; 23:446–452
Fagin A, Palmieri T, Greenhalgh D, et al.: A comparison of dexmedetomidine and midazolam for sedation in severe pediatric burn injury. J Burn Care Res 2012; 33:759–763
Garisto C, Ricci Z, Tofani L, et al.: Use of low-dose dexmedetomidine in combination with opioids and midazolam in pediatric cardiac surgical patients: Randomized controlled trial. Minerva Anestesiol 2018; 84:1053–1062
Hünseler C, Balling G, Röhlig C, et al.; Clonidine Study Group: Continuous infusion of clonidine in ventilated newborns and infants: A randomized controlled trial. Pediatr Crit Care Med 2014; 15:511–522
Tobias JD, Berkenbosch JW: Sedation during mechanical ventilation in infants and children: Dexmedetomidine versus midazolam. South Med J 2004; 97:451–455
Wolf A, McKay A, Spowart C, et al.: Prospective multicentre randomised, double-blind, equivalence study comparing clonidine and midazolam as intravenous sedative agents in critically ill children: The SLEEPS (safety profile, efficacy and equivalence in paediatric intensive care sedation) study. Health Technol Assess 2014; 18:1–212
Jiang L, Ding S, Yan H, et al.: A retrospective comparison of dexmedetomidine versus midazolam for pediatric patients with congenital heart disease requiring postoperative sedation. Pediatr Cardiol 2015; 36:993–999
Arenas-López S, Riphagen S, Tibby SM, et al.: Use of oral clonidine for sedation in ventilated paediatric intensive care patients. Intensive Care Med 2004; 30:1625–1629
Salarian S, Khosravi R, Khanbabaei G, et al.: Impact of oral clonidine on duration of opioid and benzodiazepine use in mechanically ventilated children: A randomized, double-blind, placebo-controlled study. Iran J Pharm Res 2019; 18:2157–2162
Mody K, Kaur S, Mauer EA, et al.: Benzodiazepines and development of delirium in critically ill children: Estimating the causal effect. Crit Care Med 2018; 46:1486–1491
Smith HAB, Gangopadhyay M, Goben CM, et al.: Delirium and benzodiazepines associated with prolonged ICU stay in critically ill infants and young children. Crit Care Med 2017; 45:1427–1435
Traube C, Silver G, Reeder RW, et al.: Delirium in critically ill children: An international point prevalence study. Crit Care Med 2017; 45:584–590
Ghimire LV, Chou FS: Efficacy of prophylactic dexmedetomidine in preventing postoperative junctional ectopic tachycardia in pediatric cardiac surgery patients: A systematic review and meta-analysis. Paediatr Anaesth 2018; 28:597–606
Li X, Zhang C, Dai D, et al.: Efficacy of dexmedetomidine in prevention of junctional ectopic tachycardia and acute kidney injury after pediatric cardiac surgery: A meta-analysis. Congenit Heart Dis 2018; 13:799–807
Prasad SR, Simha PP, Jagadeesh AM: Comparative study between dexmedetomidine and fentanyl for sedation during mechanical ventilation in post-operative paediatric cardiac surgical patients. Indian J Anaesth 2012; 56:547–552
Gupta P, Whiteside W, Sabati A, et al.: Safety and efficacy of prolonged dexmedetomidine use in critically ill children with heart disease. Pediatr Crit Care Med 2012; 13:660–666
Hasegawa T, Oshima Y, Maruo A, et al.: Dexmedetomidine in combination with midazolam after pediatric cardiac surgery. Asian Cardiovasc Thorac Ann 2015; 23:802–808
Su X, Meng ZT, Wu XH, et al.: Dexmedetomidine for prevention of delirium in elderly patients after non-cardiac surgery: A randomised, double-blind, placebo-controlled trial. Lancet 2016; 388:1893–1902
Kwiatkowski DM, Axelrod DM, Sutherland SM, et al.: Dexmedetomidine is associated with lower incidence of acute kidney injury after congenital heart surgery. Pediatr Crit Care Med 2016; 17:128–134
Bray RJ: Propofol infusion syndrome in children. Paediatr Anaesth 1998; 8:491–499
Parke TJ, Stevens JE, Rice AS, et al.: Metabolic acidosis and fatal myocardial failure after propofol infusion in children: Five case reports. BMJ 1992; 305:613–616
Rigby-Jones AE, Nolan JA, Priston MJ, et al.: Pharmacokinetics of propofol infusions in critically ill neonates, infants, and children in an intensive care unit. Anesthesiology 2002; 97:1393–1400
Cray SH, Holtby HM, Kartha VM, et al.: Early tracheal extubation after paediatric cardiac surgery: The use of propofol to supplement low-dose opioid anaesthesia. Paediatr Anaesth 2001; 11:465–471
Martin PH, Murthy BV, Petros AJ: Metabolic, biochemical and haemodynamic effects of infusion of propofol for long-term sedation of children undergoing intensive care. Br J Anaesth 1997; 79:276–279
Svensson ML, Lindberg L: The use of propofol sedation in a paediatric intensive care unit. Nurs Crit Care 2012; 17:198–203
Timpe EM, Eichner SF, Phelps SJ: Propofol-related infusion syndrome in critically ill pediatric patients: coincidence, association, or causation? J Pediatr Pharmacol Ther 2006; 11:17–42
Teng SN, Kaufman J, Czaja AS, et al.: Propofol as a bridge to extubation for high-risk children with congenital cardiac disease. Cardiol Young 2011; 21:46–51
Sheridan RL, Keaney T, Stoddard F, et al.: Short-term propofol infusion as an adjunct to extubation in burned children. J Burn Care Rehabil 2003; 24:356–360
Neunhoeffer F, Hanser A, Esslinger M, et al.: Ketamine infusion as a counter measure for opioid tolerance in mechanically ventilated children: A pilot study. Paediatr Drugs 2017; 19:259–265
Heiberger AL, Ngorsuraches S, Olgun G, et al.: Safety and utility of continuous ketamine infusion for sedation in mechanically ventilated pediatric patients. J Pediatr Pharmacol Ther 2018; 23:447–454
Kaul HL, Bhaskaran K, Saxena N, et al.: Alterations in intracranial pressure following ketamine anesthesia in hydrocephalic children. Indian J Pediatr 1984; 51:25–28
Wyte SR, Shapiro HM, Turner P, et al.: Ketamine-induced intracranial hypertension. Anesthesiology 1972; 36:174–176
Crumrine RS, Nulsen FE, Weiss MH: Alterations in ventricular fluid pressure during ketamine anesthesia in hydrocephalic children. Anesthesiology 1975; 42:758–761
Bar-Joseph G, Guilburd Y, Tamir A, et al.: Effectiveness of ketamine in decreasing intracranial pressure in children with intracranial hypertension. J Neurosurg Pediatr 2009; 4:40–46
Tobias JD: The use of neuromuscular-blocking agents in children. Pediatr Ann 1997; 26:482–489
Jacobi J, Farrington EA: Supportive care of the critically ill patient. In: Pharmacology Self-Assessment Program, Critical Care, Module 2. Carter BL, Lake KD, Raebel MA, et al (Eds). Kansas City, MO American College of Clinical Pharmacy, 1998, pp 129–159
Jurado L, Allison TA, Bulbis B, et al.: Neuromuscular blocking agents. In: Casebook in Clinical Pharmacokinetics and Drug Dosing. Cohen H (Ed). New York, McGraw-Hill Publishing, 2015
Johnson PN, Miller J, Gormley AK: Continuous-infusion neuromuscular blocking agents in critically ill neonates and children. Pharmacotherapy 2011; 31:609–620
Foster JG, Kish SK, Keenan CH: A national survey of critical care nurses’ practices related to administration of neuromuscular blocking agents. Am J Crit Care 2001; 10:139–145
Rhoney DH, Murry KR: National survey on the use of sedatives and neuromuscular blocking agents in the pediatric intensive care unit. Pediatr Crit Care Med 2002; 3:129–133
Martin LD, Bratton SL, Quint P, et al.: Prospective documentation of sedative, analgesic, and neuromuscular blocking agent use in infants and children in the intensive care unit: A multicenter perspective. Pediatr Crit Care Med 2001; 2:205–210
Frankel H, Jeng J, Tilly E, et al.: The impact of implementation of neuromuscular blockade monitoring standards in a surgical intensive care unit. Am Surg 1996; 62:503–506
Mueller SW, Winn R, Macht M, et al.: Neuromuscular blockade resistance during therapeutic hypothermia. Ann Pharmacother 2011; 45:e15
Playfor S, Jenkins I, Boyles C, et al.; United Kingdom Paediatric Intensive Care Society Sedation, Analgesia and Neuromuscular Blockade Working Group: Consensus guidelines for sustained neuromuscular blockade in critically ill children. Paediatr Anaesth 2007; 17:881–887
Zuppa AF, Curley MAQ: Sedation analgesia and neuromuscular blockade in pediatric critical care: Overview and current landscape. Pediatr Clin North Am 2017; 64:1103–1116
Johansen JW, Sebel PS: Development and clinical application of electroencephalographic bispectrum monitoring. Anesthesiology 2000; 93:1336–1344
Nievas IF, Spentzas T, Bogue CW: SNAP II index: An alternative to the COMFORT scale in assessing the level of sedation in mechanically ventilated pediatric patients. J Intensive Care Med 2014; 29:225–228
Thompson C, Shabanova V, Giuliano JS Jr: The SNAP index does not correlate with the state behavioral scale in intubated and sedated children. Paediatr Anaesth 2013; 23:1174–1179
Klebermass K, Olischar M, Waldhoer T, et al.: Amplitude-integrated EEG pattern predicts further outcome in preterm infants. Pediatr Res 2011; 70:102–108
Benavente-Fernández I, Lubián-López SP, Jiménez-Gómez G, et al.: Low-voltage pattern and absence of sleep-wake cycles are associated with severe hemorrhage and death in very preterm infants. Eur J Pediatr 2015; 174:85–90
Shellhaas RA, Kushwaha JS, Plegue MA, et al.: An evaluation of cerebral and systemic predictors of 18-month outcomes for neonates with hypoxic ischemic encephalopathy. J Child Neurol 2015; 30:1526–1531
Triltsch AE, Nestmann G, Orawa H, et al.: Bispectral index versus COMFORT score to determine the level of sedation in paediatric intensive care unit patients: A prospective study. Crit Care 2005; 9:R9–17
Twite MD, Zuk J, Gralla J, et al.: Correlation of the bispectral index monitor with the COMFORT scale in the pediatric intensive care unit. Pediatr Crit Care Med 2005; 6:648–53; quiz 654
Courtman SP, Wardurgh A, Petros AJ: Comparison of the bispectral index monitor with the Comfort score in assessing level of sedation of critically ill children. Intensive Care Med 2003; 29:2239–2246
Berkenbosch JW, Fichter CR, Tobias JD: The correlation of the bispectral index monitor with clinical sedation scores during mechanical ventilation in the pediatric intensive care unit. Anesth Analg 2002; 94:506–511; table of contents
Crain N, Slonim A, Pollack MM: Assessing sedation in the pediatric intensive care unit by using BIS and the COMFORT scale. Pediatr Crit Care Med 2002; 3:11–14
Grindstaff RJ, Tobias JD: Applications of bispectral index monitoring in the pediatric intensive care unit. J Intensive Care Med 2004; 19:111–116
Amigoni A, Mozzo E, Brugnaro L, et al.: Assessing sedation in a pediatric intensive care unit using comfort behavioural scale and bispectral index: These tools are different. Minerva Anestesiol 2012; 78:322–329
Aneja R, Heard AM, Fletcher JE, et al.: Sedation monitoring of children by the bispectral index in the pediatric intensive care unit. Pediatr Crit Care Med 2003; 4:60–64
Vivien B, Langeron O, Riou B: Increase in bispectral index (BIS) while correcting a severe hypoglycemia. Anesth Analg 2002; 95:1824–1825
Mychaskiw G, Heath BJ, Eichhorn JH: Falsely elevated bispectral index during deep hypothermic circulatory arrest. Br J Anaesth 2000; 85:798–800
Azim N, Wang CY: The use of bispectral index during a cardiopulmonary arrest: A potential predictor of cerebral perfusion. Anaesthesia 2004; 59:610–612
van Dijk M, Peters JW, van Deventer P, et al.: The COMFORT behavior scale: A tool for assessing pain and sedation in infants. Am J Nurs 2005; 105:33–36
Sury MR: Accidental awareness during anesthesia in children. Paediatr Anaesth 2016; 26:468–474
Valentine SL, Nadkarni VM, Curley MA; Pediatric Acute Lung Injury Consensus Conference Group: Nonpulmonary treatments for pediatric acute respiratory distress syndrome: Proceedings from the Pediatric Acute Lung Injury Consensus Conference. Pediatr Crit Care Med 2015; 16:S73–S85
Sorce LR, Hamilton SM, Gauvreau K, et al.: Preventing corneal abrasions in critically ill children receiving neuromuscular blockade: A randomized, controlled trial. Pediatr Crit Care Med 2009; 10:171–175
Lenart SB, Garrity JA: Eye care for patients receiving neuromuscular blocking agents or propofol during mechanical ventilation. Am J Crit Care 2000; 9:188–191
Imanaka H, Taenaka N, Nakamura J, et al.: Ocular surface disorders in the critically ill. Anesth Analg 1997; 85:343–346
Hernandez EV, Mannis MJ: Superficial keratopathy in intensive care unit patients. Am J Ophthalmol 1997; 124:212–216
Cortese D, Capp L, McKinley S: Moisture chamber versus lubrication for the prevention of corneal epithelial breakdown. Am J Crit Care 1995; 4:425–428
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders. Fifth Edition. Washington, DC, American Psychiatric Association, 2013
Flacker JM, Lipsitz LA: Neural mechanisms of delirium: Current hypotheses and evolving concepts. J Gerontol A Biol Sci Med Sci 1999; 54:B239–B246
Gunther ML, Morandi A, Krauskopf E, et al.; VISIONS Investigation, VISualizing Icu SurvivOrs Neuroradiological Sequelae: The association between brain volumes, delirium duration, and cognitive outcomes in intensive care unit survivors: The VISIONS cohort magnetic resonance imaging study. Crit Care Med 2012; 40:2022–2032
Karnik NS, Joshi SV, Paterno C, et al.: Subtypes of pediatric delirium: A treatment algorithm. Psychosomatics 2007; 48:253–257
Meagher DJ, Trzepacz PT: Motoric subtypes of delirium. Semin Clin Neuropsychiatry 2000; 5:75–85
Peterson JF, Pun BT, Dittus RS, et al.: Delirium and its motoric subtypes: A study of 614 critically ill patients. J Am Geriatr Soc 2006; 54:479–484
Siddiqi N, Harrison JK, Clegg A, et al.: Interventions for preventing delirium in hospitalised non-ICU patients. Cochrane Database Syst Rev 2016; 3:CD005563
Siddiqi N, House AO, Holmes JD: Occurrence and outcome of delirium in medical in-patients: A systematic literature review. Age Ageing 2006; 35:350–364
Grover S, Sharma A, Aggarwal M, et al.: Comparison of symptoms of delirium across various motoric subtypes. Psychiatry Clin Neurosci 2014; 68:283–291
Pandharipande P, Cotton BA, Shintani A, et al.: Motoric subtypes of delirium in mechanically ventilated surgical and trauma intensive care unit patients. Intensive Care Med 2007; 33:1726–1731
Alvarez RV, Palmer C, Czaja AS, et al.: Delirium is a common and early finding in patients in the pediatric cardiac intensive care unit. J Pediatr 2018; 195:206–212
Meyburg J, Dill ML, Traube C, et al.: Patterns of postoperative delirium in children. Pediatr Crit Care Med 2017; 18:128–133
Silver G, Traube C, Kearney J, et al.: Detecting pediatric delirium: development of a rapid observational assessment tool. Intensive Care Med 2012; 38:1025–1031
Simone S, Edwards S, Lardieri A, et al.: Implementation of an ICU bundle: An interprofessional quality improvement project to ehance delirium management and monitor delirium prevalence in a single PICU. Pediatr Crit Care Med 2017; 18:531–540
Smith HA, Boyd J, Fuchs DC, et al.: Diagnosing delirium in critically ill children: Validity and reliability of the pediatric confusion assessment method for the intensive care unit. Crit Care Med 2011; 39:150–157
Smith HA, Gangopadhyay M, Goben CM, et al.: The preschool confusion assessment method for the ICU: Valid and reliable delirium monitoring for critically ill infants and children. Crit Care Med 2016; 44:592–600
Traube C, Silver G, Kearney J, et al.: Cornell assessment of pediatric delirium: A valid, rapid, observational tool for screening delirium in the PICU. Crit Care Med 2014; 42:656–663
Cano Londoño EM, Mejía Gil IC, Uribe Hernández K, et al.: Delirium during the first evaluation of children aged five to 14 years admitted to a paediatric critical care unit. Intensive Crit Care Nurs 2018; 45:37–43
de Castro REV, Prata-Barbosa A, de Magalhães-Barbosa MC, et al.: Validity and reliability of the Brazilian Portuguese version of the pediatric confusion assessment method for the ICU. Pediatr Crit Care Med 2020; 21:e39–e46
Grover S, Kate N, Malhotra S, et al.: Symptom profile of delirium in children and adolescent–Does it differ from adults and elderly? Gen Hosp Psychiatry 2012; 34:626–632
Ista E, van Beusekom B, van Rosmalen J, et al.: Validation of the SOS-PD scale for assessment of pediatric delirium: A multicenter study. Crit Care 2018; 22:309
Luetz A, Gensel D, Müller J, et al.: Validity of different delirium assessment tools for critically ill children: Covariates matter. Crit Care Med 2016; 44:2060–2069
Matsuishi Y, Hoshino H, Shimojo N, et al.: Verifying the Japanese version of the preschool confusion assessment method for the ICU (psCAM-ICU). Acute Med Surg 2019; 6:287–293
Patel AK, Biagas KV, Clarke EC, et al.: Delirium in children after cardiac bypass surgery. Pediatr Crit Care Med 2017; 18:165–171
Schieveld JN, Leroy PL, van Os J, et al.: Pediatric delirium in critical illness: Phenomenology, clinical correlates and treatment response in 40 cases in the pediatric intensive care unit. Intensive Care Med 2007; 33:1033–1040
Rodríguez-Rubio M, Álvarez-Rojas E, de la Oliva P: The diagnosis of delirium in pediatric intensive care: A burdensome yet essential task. Med Intensiva (Engl Ed) 2020; 44:128
Dervan LA, Di Gennaro JL, Farris RWD, et al.: Delirium in a tertiary PICU: Risk factors and outcomes. Pediatr Crit Care Med 2020; 21:21–32
Silver G, Traube C, Gerber LM, et al.: Pediatric delirium and associated risk factors: A single-center prospective observational study. Pediatr Crit Care Med 2015; 16:303–309
Traube C, Ariagno S, Thau F, et al.: Delirium in hospitalized children with cancer: Incidence and associated risk factors. J Pediatr 2017; 191:212–217
Smeets IA, Tan EY, Vossen HG, et al.: Prolonged stay at the paediatric intensive care unit associated with paediatric delirium. Eur Child Adolesc Psychiatry 2010; 19:389–393
Paterson RS, Kenardy JA, De Young AC, et al.: Delirium in the critically ill child: Assessment and sequelae. Dev Neuropsychol 2017; 42:387–403
Canter MO, Tanguturi YC, Ellen Wilson J, et al.: Prospective validation of the preschool confusion assessment method for the ICU to screen for delirium in infants less than 6 months old. Crit Care Med 2021; 49:e902–e909
Valdivia HR, Carlin KE: Determining interrater reliability of the Cornell assessment of pediatric delirium screening tool among PICU nurses. Pediatr Crit Care Med 2019; 20:e216–e220
Silver GH, Kearney JA, Kutko MC, et al.: Infant delirium in pediatric critical care settings. Am J Psychiatry 2010; 167:1172–1177
Van Tuijl SG, Van Cauteren YJ, Pikhard T, et al.: Management of pediatric delirium in critical illness: A practical update. Minerva Anestesiol 2015; 81:333–341
Practice guideline for the treatment of patients with delirium. American Psychiatric Association. Am J Psychiatry 1999; 156:1–20
Smith HA, Brink E, Fuchs DC, et al.: Pediatric delirium: Monitoring and management in the pediatric intensive care unit. Pediatr Clin North Am 2013; 60:741–760
Patel AK, Bell MJ, Traube C: Delirium in pediatric critical care. Pediatr Clin North Am 2017; 64:1117–1132
Traube C, Silver G: Identify delirium, then investigate for underlying etiology. Pediatr Crit Care Med 2018; 19:86–87
Shukry M, Clyde MC, Kalarickal PL, et al.: Does dexmedetomidine prevent emergence delirium in children after sevoflurane-based general anesthesia? Paediatr Anaesth 2005; 15:1098–1104
Kain ZN, MacLaren JE, Herrmann L, et al.: Preoperative melatonin and its effects on induction and emergence in children undergoing anesthesia and surgery. Anesthesiology 2009; 111:44–49
Pandharipande PP, Pun BT, Herr DL, et al.: Effect of sedation with dexmedetomidine vs lorazepam on acute brain dysfunction in mechanically ventilated patients: The MENDS randomized controlled trial. JAMA 2007; 298:2644–2653
Maldonado JR, Wysong A, van der Starre PJ, et al.: Dexmedetomidine and the reduction of postoperative delirium after cardiac surgery. Psychosomatics 2009; 50:206–217
Riker RR, Shehabi Y, Bokesch PM, et al.; SEDCOM (Safety and Efficacy of Dexmedetomidine Compared with Midazolam) Study Group: Dexmedetomidine vs midazolam for sedation of critically ill patients: A randomized trial. JAMA 2009; 301:489–499
Su F, Hammer GB: Dexmedetomidine: Pediatric pharmacology, clinical uses and safety. Expert Opin Drug Saf 2011; 10:55–66
Reade MC, Eastwood GM, Bellomo R, et al.; DahLIA Investigators; Australian and New Zealand Intensive Care Society Clinical Trials Group: Effect of dexmedetomidine added to standard care on ventilator-free time in patients with agitated delirium: A randomized clinical trial. JAMA 2016; 315:1460–1468
Girard TD, Exline MC, Carson SS, et al.; MIND-USA Investigators: Haloperidol and ziprasidone for treatment of delirium in critical illness. N Engl J Med 2018; 379:2506–2516
Joyce C, Witcher R, Herrup E, et al.: Evaluation of the safety of quetiapine in treating delirium in critically ill children: A retrospective review. J Child Adolesc Psychopharmacol 2015; 25:666–670
Capino AC, Miller JL, Johnson PN: Clonidine for sedation and analgesia and withdrawal in critically ill infants and children. Pharmacotherapy 2016; 36:1290–1299
Schieveld JN, Leentjens AF: Delirium in severely ill young children in the pediatric intensive care unit (PICU). J Am Acad Child Adolesc Psychiatry 2005; 44:392–4; discussion 395
Trzepacz PT: Delirium. Advances in diagnosis, pathophysiology, and treatment. Psychiatr Clin North Am 1996; 19:429–448
Turkel SB, Hanft A: The pharmacologic management of delirium in children and adolescents. Paediatr Drugs 2014; 16:267–274
Franck LS, Harris SK, Soetenga DJ, et al.: The withdrawal assessment tool-1 (WAT-1): An assessment instrument for monitoring opioid and benzodiazepine withdrawal symptoms in pediatric patients. Pediatr Crit Care Med 2008; 9:573–580
Best KM, Boullata JI, Curley MA: Risk factors associated with iatrogenic opioid and benzodiazepine withdrawal in critically ill pediatric patients: A systematic review and conceptual model. Pediatr Crit Care Med 2015; 16:175–183
Oschman A, McCabe T, Kuhn RJ: Dexmedetomidine for opioid and benzodiazepine withdrawal in pediatric patients. Am J Health Syst Pharm 2011; 68:1233–1238
Fernández-Carrión F, Gaboli M, González-Celador R, et al.: Withdrawal syndrome in the pediatric intensive care unit. Incidence and risk factors. Med Intensiva 2013; 37:67–74
Ista E, de Hoog M, Tibboel D, et al.: Psychometric evaluation of the Sophia observation withdrawal symptoms scale in critically ill children. Pediatr Crit Care Med 2013; 14:761–769
Best KM, Wypij D, Asaro LA, et al.; Randomized Evaluation of Sedation Titration For Respiratory Failure Study Investigators: Patient, process, and system predictors of iatrogenic withdrawal syndrome in critically ill children. Crit Care Med 2017; 45:e7–e15
Katz R, Kelly HW, Hsi A: Prospective study on the occurrence of withdrawal in critically ill children who receive fentanyl by continuous infusion. Crit Care Med 1994; 22:763–767
Amigoni A, Mondardini MC, Vittadello I, et al.; Network of Paediatric Intensive Care Unit Study Group (TIPNet): Withdrawal assessment tool-1 monitoring in PICU: A multicenter study on iatrogenic withdrawal syndrome. Pediatr Crit Care Med 2017; 18:e86–e91
Franck LS, Naughton I, Winter I: Opioid and benzodiazepine withdrawal symptoms in paediatric intensive care patients. Intensive Crit Care Nurs 2004; 20:344–351
Ista E, van Dijk M, Gamel C, et al.: Withdrawal symptoms in critically ill children after long-term administration of sedatives and/or analgesics: A first evaluation. Crit Care Med 2008; 36:2427–2432
Thompson RZ, Gardner BM, Autry EB, et al.: Survey of the current use of dexmedetomidine and management of withdrawal symptoms in critically ill children. J Pediatr Pharmacol Ther 2019; 24:16–21
Banasch HL, Dersch-Mills DA, Boulter LL, et al.: Dexmedetomidine use in a pediatric intensive care unit: A retrospective cohort study. Ann Pharmacother 2018; 52:133–139
Burbano NH, Otero AV, Berry DE, et al.: Discontinuation of prolonged infusions of dexmedetomidine in critically ill children with heart disease. Intensive Care Med 2012; 38:300–307
Carney L, Kendrick J, Carr R: Safety and effectiveness of dexmedetomidine in the pediatric intensive care unit (SAD-PICU). Can J Hosp Pharm 2013; 66:21–27
Haenecour AS, Seto W, Urbain CM, et al.: Prolonged dexmedetomidine infusion and drug withdrawal in critically ill children. J Pediatr Pharmacol Ther 2017; 22:453–460
Whalen LD, Di Gennaro JL, Irby GA, et al.: Long-term dexmedetomidine use and safety profile among critically ill children and neonates. Pediatr Crit Care Med 2014; 15:706–714
Hughes J, Gill A, Leach HJ, et al.: A prospective study of the adverse effects of midazolam on withdrawal in critically ill children. Acta Paediatr 1994; 83:1194–1199
Kaltenbach K, Finnegan LP: Neonatal abstinence syndrome, pharmacotherapy and developmental outcome. Neurobehav Toxicol Teratol 1986; 8:353–355
Finnegan LP, Connaughton JF Jr, Kron RE, et al.: Neonatal abstinence syndrome: Assessment and management. Addict Dis 1975; 2:141–158
Franck LS, Scoppettuolo LA, Wypij D, et al.: Validity and generalizability of the Withdrawal Assessment Tool-1 (WAT-1) for monitoring iatrogenic withdrawal syndrome in pediatric patients. Pain 2012; 153:142–148
Ista E, van Dijk M, de Hoog M, et al.: Construction of the Sophia observation withdrawal symptoms-scale (SOS) for critically ill children. Intensive Care Med 2009; 35:1075–1081
Chiu AW, Contreras S, Mehta S, et al.: Iatrogenic opioid withdrawal in critically ill patients: A review of assessment tools and management. Ann Pharmacother 2017; 51:1099–1111
Bichaff P, Setani KT, Motta EHG, et al.: Opioid tapering and weaning protocols in pediatric critical care units: A systematic review. Rev Assoc Med Bras (1992) 2018; 64:909–915
Meyer MM, Berens RJ: Efficacy of an enteral 10-day methadone wean to prevent opioid withdrawal in fentanyl-tolerant pediatric intensive care unit patients. Pediatr Crit Care Med 2001; 2:329–333
Bowens CD, Thompson JA, Thompson MT, et al.: A trial of methadone tapering schedules in pediatric intensive care unit patients exposed to prolonged sedative infusions. Pediatr Crit Care Med 2011; 12:504–511
Berens RJ, Meyer MT, Mikhailov TA, et al.: A prospective evaluation of opioid weaning in opioid-dependent pediatric critical care patients. Anesth Analg 2006; 102:1045–1050
Dervan LA, Yaghmai B, Watson RS, et al.: The use of methadone to facilitate opioid weaning in pediatric critical care patients: A systematic review of the literature and meta-analysis. Paediatr Anaesth 2017; 27:228–239
Siddappa R, Fletcher JE, Heard AM, et al.: Methadone dosage for prevention of opioid withdrawal in children. Paediatr Anaesth 2003; 13:805–810
Lugo RA, MacLaren R, Cash J, et al.: Enteral methadone to expedite fentanyl discontinuation and prevent opioid abstinence syndrome in the PICU. Pharmacotherapy 2001; 21:1566–1573
van der Vossen AC, van Nuland M, Ista EG, et al.: Oral lorazepam can be substituted for intravenous midazolam when weaning paediatric intensive care patients off sedation. Acta Paediatr 2018; 107:1594–1600
Deutsch ES, Nadkarni VM: Clonidine prophylaxis for narcotic and sedative withdrawal syndrome following laryngotracheal reconstruction. Arch Otolaryngol Head Neck Surg 1996; 122:1234–1238
Lee MM, Caylor K, Gockenbach N: Evaluating the transition from dexmedetomidine to clonidine for the prevention of withdrawal in critically ill pediatric patients. J Pediatr Pharmacol Ther 2020; 25:104–110
Lardieri AB, Fusco NM, Simone S, et al.: Effects of clonidine on withdrawal from long-term dexmedetomidine in the pediatric patient. J Pediatr Pharmacol Ther 2015; 20:45–53
Abdouni R, Reyburn-Orne T, Youssef TH, et al.: Impact of a standardized treatment guideline for pediatric iatrogenic opioid dependence: A quality improvement initiative. J Pediatr Pharmacol Ther 2016; 21:54–65
Amirnovin R, Sanchez-Pinto LN, Okuhara C, et al.: Implementation of a risk-stratified opioid and benzodiazepine weaning protocol in a pediatric cardiac ICU. Pediatr Crit Care Med 2018; 19:1024–1032
Sanchez-Pinto LN, Nelson LP, Lieu P, et al.: Implementation of a risk-stratified opioid weaning protocol in a pediatric intensive care unit. J Crit Care 2018; 43:214–219
Vipond JM, Heiberger AL, Thompson PA, et al.: Shortened taper duration after implementation of a standardized protocol for iatrogenic benzodiazepine and opioid withdrawal in pediatric patients: Results of a cohort study. Pediatr Qual Saf 2018; 3:e079
Solodiuk JC, Greco CD, O’Donnell KA, et al.: Effect of a sedation weaning protocol on safety and medication use among hospitalized children post critical illness. J Pediatr Nurs 2019; 49:18–23
Davidson JE, Aslakson RA, Long AC, et al.: Guidelines for family-centered care in the neonatal, pediatric, and adult ICU. Crit Care Med 2017; 45:103–128
Playfor S, Thomas D, Choonara I: Recollection of children following intensive care. Arch Dis Child 2000; 83:445–448
Chahraoui K, Laurent A, Bioy A, et al.: Psychological experience of patients 3 months after a stay in the intensive care unit: A descriptive and qualitative study. J Crit Care 2015; 30:599–605
Bonnet MH, Berry RB, Arand DL: Metabolism during normal, fragmented, and recovery sleep. J Appl Physiol (1985) 1991; 71:1112–1118
Akerstedt T, Palmblad J, de la Torre B, et al.: Adrenocortical and gonadal steroids during sleep deprivation. Sleep 1980; 3:23–30
Palmblad J, Cantell K, Strander H, et al.: Stressor exposure and immunological response in man: Interferon-producing capacity and phagocytosis. J Psychosom Res 1976; 20:193–199
Palmblad J, Petrini B, Wasserman J, et al.: Lymphocyte and granulocyte reactions during sleep deprivation. Psychosom Med 1979; 41:273–278
Christensen J, Noel M, Mychasiuk R: Neurobiological mechanisms underlying the sleep-pain relationship in adolescence: A review. Neurosci Biobehav Rev 2019; 96:401–413
Roehrs T, Hyde M, Blaisdell B, et al.: Sleep loss and REM sleep loss are hyperalgesic. Sleep 2006; 29:145–151
Patel J, Baldwin J, Bunting P, et al.: The effect of a multicomponent multidisciplinary bundle of interventions on sleep and delirium in medical and surgical intensive care patients. Anaesthesia 2014; 69:540–549
Corser NC: Sleep of 1- and 2-year-old children in intensive care. Issues Compr Pediatr Nurs 1996; 19:17–31
Al-Samsam RH, Cullen P: Sleep and adverse environmental factors in sedated mechanically ventilated pediatric intensive care patients. Pediatr Crit Care Med 2005; 6:562–567
Cureton-Lane RA, Fontaine DK: Sleep in the pediatric ICU: An empirical investigation. Am J Crit Care 1997; 6:56–63
Kukreti V, Shamim M, Khilnani P: Intensive care unit acquired weakness in children: Critical illness polyneuropathy and myopathy. Indian J Crit Care Med 2014; 18:95–101
Choong K, Foster G, Fraser DD, et al.; Canadian Critical Care Trials Group: Acute rehabilitation practices in critically ill children: A multicenter study. Pediatr Crit Care Med 2014; 15:e270–e279
Tsuboi N, Hiratsuka M, Kaneko S, et al.: Benefits of early mobilization after pediatric liver transplantation. Pediatr Crit Care Med 2019; 20:e91–e97
Tsuboi N, Nozaki H, Ishida Y, et al.: Early mobilization after pediatric liver transplantation. J Pediatr Intensive Care 2017; 6:199–205
Choong K, Awladthani S, Khawaji A, et al.; Canadian Critical Care Trials Group: Early exercise in critically ill youth and children, a preliminary evaluation: The wEECYCLE Pilot Trial. Pediatr Crit Care Med 2017; 18:e546–e554
Choong K, Chacon MDP, Walker RG, et al.: In-bed mobilization in critically ill children: A safety and feasibility trial. J Pediatr Intensive Care 2015; 4:225–234
Choong K, Fraser D, Al-Harbi S, et al.: Functional recovery in critically ill children, the “WeeCover” multicenter study. Pediatr Crit Care Med 2018; 19:145–154
Wieczorek B, Ascenzi J, Kim Y, et al.: PICU Up!: Impact of a quality improvement intervention to promote early mobilization in critically ill children. Pediatr Crit Care Med 2016; 17:e559–e566
Ista E, Redivo J, Kananur P, et al.: ABCDEF Bundle Practices for Critically Ill Children: An International Survey of 161 PICUs in 18 Countries. Crit Care Med 2022; 50:114-125
Ista E, Scholefield BR, Manning JC, et al.; EU PARK-PICU Collaborators: Mobilization practices in critically ill children: A European point prevalence study (EU PARK-PICU). Crit Care 2020; 24:368
Bauchner H, Vinci R, Bak S, et al.: Parents and procedures: A randomized controlled trial. Pediatrics 1996; 98:861–867
Béranger A, Pierron C, de Saint Blanquat L, et al.: Communication, information, and roles of parents in the pediatric intensive care unit: A review article. Arch Pediatr 2017; 24:265–272
Davidson JE: Family-centered care: Meeting the needs of patients’ families and helping families adapt to critical illness. Crit Care Nurse 2009; 29:28–34; quiz 35
Maxton FJ: Parental presence during resuscitation in the PICU: The parents’ experience. Sharing and surviving the resuscitation: A phenomenological study. J Clin Nurs 2008; 17:3168–3176
McAlvin SS, Carew-Lyons A: Family presence during resuscitation and invasive procedures in pediatric critical care: A systematic review. Am J Crit Care 2014; 23:477–84; quiz 485
Piira T, Sugiura T, Champion GD, et al.: The role of parental presence in the context of children’s medical procedures: A systematic review. Child Care Health Dev 2005; 31:233–243
Smith AB, Hefley GC, Anand KJ: Parent bed spaces in the PICU: Effect on parental stress. Pediatr Nurs 2007; 33:215–221
Çakmak E, Karaçam Z: The correlation between mothers’ participation in infant care in the NICU and their anxiety and problem-solving skill levels in caregiving. J Matern Fetal Neonatal Med 2018; 31:21–31
Rennick JE, Stremler R, Horwood L, et al.: A pilot randomized controlled trial of an intervention to promote psychological well-being in critically ill children: Soothing through touch, reading, and music. Pediatr Crit Care Med 2018; 19:e358–e366
Sanders RC Jr, Nett ST, Davis KF, et al.; National Emergency Airway Registry for Children NEAR4KIDS Investigators; Pediatric Acute Lung Injury and Sepsis Investigators Network: Family presence during pediatric tracheal intubations. JAMA Pediatr 2016; 170:e154627
Bailey E, Timmons S: Noise levels in PICU: An evaluative study. Paediatr Nurs 2005; 17:22–26
Kramer B, Joshi P, Heard C: Noise pollution levels in the pediatric intensive care unit. J Crit Care 2016; 36:111–115
Milette IH, Carnevale FA: I’m trying to heal…noise levels in a pediatric intensive care unit. Dynamics 2003; 14:14–21
Zahr LK, de Traversay J: Premature infant responses to noise reduction by earmuffs: Effects on behavioral and physiologic measures. J Perinatol 1995; 15:448–455
Jousselme C, Vialet R, Jouve E, et al.: Efficacy and mode of action of a noise-sensor light alarm to decrease noise in the pediatric intensive care unit: A prospective, randomized study. Pediatr Crit Care Med 2011; 12:e69–e72
Wang D, Aubertin C, Barrowman N, et al.: Reduction of noise in the neonatal intensive care unit using sound-activated noise meters. Arch Dis Child Fetal Neonatal Ed 2014; 99:F515–F516
Elander G, Hellström G: Reduction of noise levels in intensive care units for infants: Evaluation of an intervention program. Heart Lung 1995; 24:376–379
Liu WF; NIC/Q 2005 Physical Environment Exploratory Group: The impact of a noise reduction quality improvement project upon sound levels in the open-unit-design neonatal intensive care unit. J Perinatol 2010; 30:489–496
Khalesi N, Khosravi N, Ranjbar A, et al.: The effectiveness of earmuffs on the physiologic and behavioral stability in preterm infants. Int J Pediatr Otorhinolaryngol 2017; 98:43–47
Duran R, Ciftdemir NA, Ozbek UV, et al.: The effects of noise reduction by earmuffs on the physiologic and behavioral responses in very low birth weight preterm infants. Int J Pediatr Otorhinolaryngol 2012; 76:1490–1493
Abdeyazdan Z, Ghasemi S, Marofi M, et al.: Motor responses and weight gaining in neonates through use of two methods of earmuff and receiving silence in NICU. ScientificWorldJournal 2014; 2014:864780
Fink EL, Beers SR, Houtrow AJ, et al.; PICU-Rehabilitation Study Group: Early protocolized versus usual care rehabilitation for pediatric neurocritical care patients: A randomized controlled trial. Pediatr Crit Care Med 2019; 20:540–550
Betters KA, Hebbar KB, Farthing D, et al.: Development and implementation of an early mobility program for mechanically ventilated pediatric patients. J Crit Care 2017; 41:303–308
Colwell BRL, Williams CN, Kelly SP, et al.: Mobilization therapy in the pediatric intensive care unit: A multidisciplinary quality improvement initiative. Am J Crit Care 2018; 27:194–203
Hanna ES, Zhao S, Shannon CN, et al.: Changes in provider perceptions regarding early mobility in the PICU. Pediatr Crit Care Med 2020; 21:e30–e38