Intensive Care Medicine

, Volume 32, Issue 8, pp 1125–1136

Consensus guidelines on sedation and analgesia in critically ill children

Authors

    • Paediatric Intensive Care UnitRoyal Manchester Children's Hospital
  • Ian Jenkins
    • Paediatric Intensive Care UnitRoyal Manchester Children's Hospital
  • Carolyne Boyles
    • Paediatric Intensive Care UnitRoyal Manchester Children's Hospital
  • Imti Choonara
    • Paediatric Intensive Care UnitRoyal Manchester Children's Hospital
  • Gerald Davies
    • Paediatric Intensive Care UnitRoyal Manchester Children's Hospital
  • Tim Haywood
    • Paediatric Intensive Care UnitRoyal Manchester Children's Hospital
  • Gillian Hinson
    • Paediatric Intensive Care UnitRoyal Manchester Children's Hospital
  • Anton Mayer
    • Paediatric Intensive Care UnitRoyal Manchester Children's Hospital
  • Neil Morton
    • Paediatric Intensive Care UnitRoyal Manchester Children's Hospital
  • Tanya Ralph
    • Paediatric Intensive Care UnitRoyal Manchester Children's Hospital
  • Andrew Wolf
    • Paediatric Intensive Care UnitRoyal Manchester Children's Hospital
  • United Kingdom Paediatric Intensive Care Society Sedation
    • Paediatric Intensive Care UnitRoyal Manchester Children's Hospital
  • Analgesia and Neuromuscular Blockade Working Group
    • Paediatric Intensive Care UnitRoyal Manchester Children's Hospital
Special Article

DOI: 10.1007/s00134-006-0190-x

Cite this article as:
Playfor, S., Jenkins, I., Boyles, C. et al. Intensive Care Med (2006) 32: 1125. doi:10.1007/s00134-006-0190-x

Abstract

Objective

The United Kingdom Paediatric Intensive Care Society Sedation, Analgesia and Neuromuscular Blockade Working Group is a multi-disciplinary expert panel created to produce consensus guidelines on sedation and analgesia in critically ill children and forward knowledge in these areas. Sedation and analgesia are recognised as important areas of critical care practice and adult clinical practice guidelines in these fields remain amongst the most popular of those produced by the Society of Critical Care Medicine. However, similar clinical practice guidelines have not previously been produced for the critically ill paediatric patient.

Design

A modified Delphi technique was used to allow the Working Group to anonymously consider draft recommendations in three Delphi rounds with predetermined levels of agreement. This process was supported by a total of four consensus conferences. Once consensus had been reached, a systematic review of the available literature was carried out.

Outcome

A set of consensus guidelines was produced including 20 key recommendations, 10 relating to the provision of analgesia and 10 relating to the sedation of critically ill children. An evaluation of the existing literature supporting these recommendations is provided.

Conclusions

Multi-disciplinary consensus guidelines for maintenance sedation and analgesia in critically ill children have been successfully produced and are supported by levels of evidence (excluding sedation and analgesia for procedures and excluding neonates). The working group has highlighted the paucity of high-quality evidence in these important clinical areas and this emphasises the need for further randomised clinical trials in this area.

Keywords

Paediatric intensive caremorphinefentanylmidazolampropofolwithdrawalcomfort

Copyright information

© Springer-Verlag 2006