Variations and similarities in clinical management of neonatal abstinence syndrome: Findings of a Canadian survey

Paediatrics & Child Health
Katie MurphyKimberly Dow

Abstract

There are no evidence-based national guidelines for managing neonatal abstinence syndrome (NAS) and surveys from other countries have demonstrated considerable variations in practice. To describe NAS management practices in Canada. The directors of all Level 2 and Level 3 neonatal intensive care units (NICUs) were contacted to request their participation in a structured telephone survey. Frequency distributions were generated and associations between practice variations and unit type (Level 2 or 3) and size were examined. Personnel at 65 of 103 sites (63.1%) participated. Most (92.3%) stated their hospital has a written NAS practice guideline. The majority (89.5%) use a version of Finnegan's scoring system to monitor signs. If pharmacological treatment is required, 89.2% admit infants to the NICU and 93.8% routinely use cardiorespiratory monitors when treatment is initiated. Morphine is the first-line medication at most sites (96.9%). There was greater variability in terms of other practices: 44.6% observe at-risk infants in the NICU, while 52.3% allow them to room-in with their mothers; 65.1% use adjunct medications; 36.9% and 38.9% will discharge infants on the first-line and adjunct medications respectively, and 53.8% report...Continue Reading

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Citations

Jul 12, 2019·Journal of Midwifery & Women's Health·Rebecca R S Clark
Nov 21, 2018·Paediatrics & Child Health·Paul Thiessen
Mar 27, 2021·Neurotoxicology and Teratology·Shikhar ShresthaLudmila N Bakhireva
Aug 24, 2021·The Journal of Pediatric Pharmacology and Therapeutics : JPPT : the Official Journal of PPAG·Eva M ByerleyJulia D Muzzy Williamson

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