The implementation of systematic pain and sedation management has no impact on outcome in extremely preterm infants

Acta Paediatrica
Philipp DeindlMonika Olischar

Abstract

This study compared the short-term and neurodevelopmental outcomes of extremely preterm infants before and after the implementation of a protocol to manage neonatal pain and sedation. Our study cohort comprised 140 extremely preterm infants from two neonatal intensive care units. We retrospectively analysed opiate exposure, time on mechanical ventilation, inotropic support, nutritional aspects and growth 12 months before (controls) vs 12 months after (intervention) the implementation of the Vienna Protocol for Neonatal Pain and Sedation. Infants were evaluated at the corrected age of 12 months using the Bayley Scales of Infant Development - Second Edition. After the protocol was implemented, the cumulative opiate dose increased from a baseline of 15 mg/kg ± 41 to 89 mg/kg ± 228 morphine equivalents. Time on mechanical ventilation, inotropic support, length of parenteral nutrition, growth, length of stay and in-hospital morbidity were similar before and after the implementation, with no differences between the groups in mental, motor and behavioural development at the one-year follow-up. However, opiate exposure was a possible risk factor for lower behaviour rating scores (estimate = -0.04; p = 0.006). [Correction added on 23 Fe...Continue Reading

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Citations

Jun 9, 2016·Acta Paediatrica·Ricardo CarbajalPierre-Louis Leger
Jun 9, 2016·Acta Paediatrica·Kanwaljeet J S Anand
Dec 29, 2017·Scandinavian Journal of Caring Sciences·Randi Dovland AndersenMaria Gradin
Jun 16, 2017·Journal of Perinatology : Official Journal of the California Perinatal Association·D RanaR Dhanireddy
Sep 7, 2018·Canadian Respiratory Journal : Journal of the Canadian Thoracic Society·Gustavo RochaHercília Guimarães
Oct 4, 2020·Journal of Perinatology : Official Journal of the California Perinatal Association·Mikayla E MorganClayton J Shuman
Oct 21, 2020·Developmental Medicine and Child Neurology·Haixia GaoBin Wang
Oct 18, 2020·Pediatric Research·Kanwaljeet J S Anand
Dec 29, 2020·International Journal of Nursing Studies·Randi Dovland AndersenMats Eriksson

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