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Pharmacology II
O-103 Sedation And Analgesia For Neonates In Nicus Across Europe: The Europain Survey
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  1. R Carbajal1,
  2. M Eriksson2,
  3. E Courtois1,
  4. A Avila-Alvarez3,
  5. A Berger4,
  6. P Lago5,
  7. B Van Overmeire6,
  8. T Papadouri7,
  9. ML Ilmoja8,
  10. T Pölkki9,
  11. M Schroth10,
  12. K Sarafidis11,
  13. R Tameliene12,
  14. S Attard Montalto13,
  15. S Simons14,
  16. RD Andersen15,
  17. A Dobrzanska16,
  18. C Matos17,
  19. E Boyle18,
  20. E Europain19 Study group,
  21. H Lagercrantz20,
  22. L Bergqvist20,
  23. KJS Anand21
  1. 1Emergency Department, Hôpital Armand-Trousseau, Paris, France
  2. 2Centre for Health Care Sciences, Örebro University Hospital, Örebro, Sweden
  3. 3NICU, Complexo Hospitalario Universitario de a Coruña, a Coruña, Spain
  4. 4NICU, Univ. Klinik F. Kinder and Jugendheilkunde, Vienna, Austria
  5. 5NICU, University of Padova, Padova, Italy
  6. 6NICU, Erasme Hospital, Bruxelles, Belgium
  7. 7NICU, Arch. Makarios Hospital, Nicosia, Cyprus
  8. 8NICU, Tallinn Children’s Hospital, Tallinn, Estonia
  9. 9NICU, Institute of Health Sciences University of Oulu, Oulu, Finland
  10. 10NICU, Cnopf’sche Kinderklinik, Nuremberg, Germany
  11. 11NICU, Aristotle University of Thessaloniki, Thessaloniki, Greece
  12. 12NICU, Perinatal Center, Kaunas, Lithuania
  13. 13NICU, Mater Dei Hospital, Msida, Malta
  14. 14NICU, Erasmus MC Sophia Children’s Hospital, Rotterdam, Netherlands
  15. 15NICU, Telemark Hospital, Skien, Norway
  16. 16NICU, Children’s Memorial Health Institute, Warsaw, Poland
  17. 17NICU, Maternidade Dr Alfredo Da Costa, Lisboa, Portugal
  18. 18NICU, University of Leicester, Leicester, UK
  19. 19Europain Study Group, Europain Study Group, Paris, France
  20. 20NICU, Karolinska University Hospital, Stockholm, Sweden
  21. 21Department of Pediatrics Critical Care Medecine Division, University of Tennessee Health Science Center, Memphis, USA

Abstract

Background Pain and stress induced by mechanical ventilation, invasive procedures, or painful diseases supports the use of sedation/analgesia (S/A) in newborns admitted to Neonatal Intensive Care Units (NICUs). To date, these practices have not been studied at a large scale.

Objective To determine current clinical practices regarding the use of S/A drugs in NICUs across Europe.

Methods This epidemiological observational study on bedside clinical practices regarding S/A collected data for all neonates in participating NICUs until the infant left the unit (discharge, death, transfer) or for up to 28 days. Data collection occurred via an online database for 1 month at each NICU. All neonates up to 44 weeks gestation were included.

Results From October 2012 to June 2013, 243 NICUs from 18 European countries collected data on 6680 eligible neonates. Of these, 2142 received tracheal ventilation (TV), 1496 non-invasive ventilation (NIV) and 3042 only spontaneous ventilation (SV). The median (IQR) gestational age of TV, NIV and SV neonates were 32.1 (28.1–37.4), 33.6 (31.0–36.6) and 37.9 (35.0–39.9), respectively (p < 0.001). Overall, more TV neonates [81.5% (n = 1746)] received S/A drugs than NIV neonates [17.8% (n = 266)] and SV neonates [9.3% (n = 282)]; p < 0.001. Fig. shows the rate of S/A use by country; table shows S/A drugs used.

Abstract O-103 Table 1
Abstract O-103 Table 1

Sedation/analgesia drugs used in TV, NIV and SV neonates neonates

Abstract O-103 Figure 1
Abstract O-103 Figure 1

Rate of Analgesia/sedation in 2142 tracheal ventilated neonates (TV) and 1496 Non invasive ventilated neonates (NIV) admitted to NIUC in 18 European countries

Conclusions Most ventilated but few non-ventilated neonates (NIV and SV) receive S/A therapy in European NICUs. Wide variations in S/A use, drugs used, and mode of administration (continuous, bolus, or both) exist among countries.

https://doi.org/10.1136/archdischild-2014-307384.170

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