<h3>Background</h3> Despite an increasing awareness regarding pain management in neonates and the availability of published guidelines for treatment procedural pain, preterm experience leading to short- long-term detrimental effects. <h3>Objective</h3> To assess frequency use analgesics invasive procedures associated burden this population. <h3>Methods</h3> For 151 neonates, we prospectively recorded all painful procedures, including number attempts required, analgesic therapy used during...

The aim of this study was to test the reliability and validity COMFORT scale as a postoperative pain instrument for children aged 0–3 years. Subjects were 158 neonates toddlers after major abdominal or thoracic surgery. Trained nurses rated children's at 3, 6 9 h on Pediatric Surgical Intensive Care Unit using VAS pain. Interrater items proved be good (Kappa 0.63–0.93) all with exception item ‘Respiratory response’, which moderate 0.54). LISREL analyses showed that structure data best...

Importance Continuous morphine infusion as standard postoperative analgesic therapy in young infants is associated with unwanted adverse effects such respiratory depression.Objective To determine whether intravenous paracetamol (acetaminophen) would significantly (Ͼ30%) reduce requirements neonates and after major surgery.Design, Setting, Patients Single-center, randomized, double-blind study conducted a level 3 pediatric intensive care unit Rotterdam, the Netherlands.Patients were 71 or...

&lt;b&gt;&lt;i&gt;Objective:&lt;/i&gt;&lt;/b&gt; To study whether new pharmacological and nonpharmacological guidelines lowered numbers of painful procedures in neonates changed the amount frequency analgesic therapy as compared to results our previous 2001. &lt;b&gt;&lt;i&gt;Design:&lt;/i&gt;&lt;/b&gt; A prospective observational study. &lt;b&gt;&lt;i&gt;Setting:&lt;/i&gt;&lt;/b&gt; Level III NICU Erasmus MC-Sophia Children's Hospital, Rotterdam....

Newborns admitted to neonatal intensive care units (NICUs) undergo a variety of painful procedures and stressful events. Because the effect continuous morphine infusion in preterm neonates has not been investigated systematically, there is confusion regarding whether should be used routinely this setting.To evaluate effects intravenous on pain responses, incidence intraventricular hemorrhage (IVH), poor neurologic outcome (severe IVH, periventricular leukomalacia, or death).A randomized,...

Objectives: The original COMFORT scale, including both observational and physiologic items, has been validated for measuring distress in children admitted to a pediatric intensive care unit. However, variables are influenced by drugs given the unit setting. objectives of this study were assess usefulness judgment sedation determine new cutoff points "behavioral" scale (COMFORT-B), using only items. Design: Prospective study. Setting: Pediatric university hospital Patients: Seventy-eight...

Does pain or tissue damage in early life lead to hyperalgesia persisting into childhood? We performed a cross-sectional study 164 infants investigate whether major surgery within the first 3 months of increases sensitivity subsequent and elucidate same dermatome different leads differences sensitivity. All received standard intraoperative postoperative management, with rescue analgesia guided by treatment algorithm. Differences during were assessed fentanyl intake (nor)epinephrine plasma...

Pain assessment is essential to tailor intensive care of neonates. The present focus on acute procedural pain; pain longer duration remains a challenge. We therefore tested modified version the COMFORT-behavior scale-named COMFORTneo-for its psychometric qualities in Neonatal Intensive Care Unit setting.In clinical observational study, nurses assessed patients with COMFORTneo and Numeric Rating Scales (NRS) for distress, respectively. Interrater reliability, concurrent validity, sensitivity...

Newborns on ventilatory support often receive morphine to induce analgesia. Animal experiments suggest that this may impair subsequent cognitive and behavioral development. There are sparse human data long-term effects of neonatal morphine. We aimed investigate the continuous administered in period child’s functioning. conducted a follow-up study among 5-year-olds who, as mechanically ventilated neonates, had participated placebo-controlled trial administration pain neurologic outcome. They...

van Dijk, Monique PhD, RN; Peters, Jeroen W. B. Deventer, Patricia Tibboel, Dick MD, PhD Author Information

To investigate the time course and predictive value of microvascular alterations in children with severe sepsis.Single-center, prospective observational study.Intensive care unit a level III university children's hospital.Patients septic shock, requiring administration fluid vasopressor agents and/or inotropes after correction hypovolemia, who were intubated ventilated, included.None.The microcirculation was assessed buccal mucosa, using orthogonal polarization spectral imaging, within 24...

Summary Neonatal morphine infusion of 10 μg/kg/h does not affect general functioning 8 to 9 years later and may even have a positive effect on executive function skills. Morphine is widely used treat severe pain in neonatal intensive care unit patients. Animal studies suggest adverse long-term side effects morphine, but follow-up study 5-year-old children who participated morphine-placebo controlled trial as newborns found no such the child’s functioning. This indicated that negatively...

In Brief BACKGROUND: Assessing pain in mechanically ventilated critically ill patients is a great challenge. There need for an adequate measurement tool use conscious sedated because of their questionable communicative abilities. this study, we evaluated the Behavioral Pain Scale (BPS) comparison with its deeply patients, whom BPS was developed. Additionally, combination and patient-rated Verbal Rating (VRS-4) evaluated. METHODS: We performed prospective evaluation study 80 nonparalyzed...

Introduction Neonates admitted to a neonatal intensive care unit (NICU) rely highly on intravenous (IV) therapy, for which the peripheral cannula (PIVC) is preferred device allow such therapies proceed. Placement of PIVC painful procedure and repeated attempts successful insertion should therefore be limited. We aimed quantify incidence, complications, factors associated with these complications. Methods conducted prospective observational study examine PIVC-related complications in level...

To establish frequencies of benzodiazepine and opioid withdrawal symptoms, correlations with total doses duration administration.A prospective, repeated-measures design.Two pediatric intensive care units in a university children's hospital.Seventy-nine children, aged 0 days to 16 yrs, who received intravenous midazolam and/or opioids for >5 days.None.Pediatric unit nurses assessed symptoms using the Sophia Benzodiazepine Opioid Withdrawal Checklist, which includes all (n = 24) described...

To construct a reliable and clinically practical instrument for monitoring opioids benzodiazepine withdrawal symptoms in pediatric ICU patients.Instrument development.Intensive care unit an academic children's hospital.79 patients up to age 16 years on intravenous midazolam and/or > or =5 days. An expert panel of 85 physicians nurses rated clinical relevance symptoms.During drug weaning repeated observations were performed with checklist 24 described the literature.For 76 children, 932...