Abstract
Critically ill newborns admitted to Neonatal Intensive Care Unit often require a centrally inserted central catheters (CICCs) inserted by ultrasound-guided puncture of the internal jugular or brachio-cephalic vein. Achieving an appropriate level of sedation and analgesia is paramount for procedure success and patient safety, avoiding the potential risks associated with excessive deep sedation. The aim of this study is to evaluate the feasibility of a novel protocol of sedation. Data from 46 patients were prospectively collected. The feasibility was assessed throughout the monitoring of adverse events and the incidence of spontaneous movements. The procedure was completed in 100% of cases. There were no cases of escalation of the baseline ventilatory support despite the procedure and no case of hypotension, and all spontaneous movements were controlled with additional boluses when required.
Conclusion: Our study represents the very first step towards the design of a validated protocol for analgosedation during ultrasound-guided CICC insertion in NICU.
What is Known: • Critically ill newborns admitted to Neonatal Intensive Care Unit often require a centrally inserted central catheter. • Achieving an appropriate level of sedation and analgesia is paramount for procedure success and patient safety, avoiding the potential risks associated with excessive deep sedation. | |
What is New: • The use of this new protocol for analgosedation is able to achieve a good level of sedation and pain control without significant adverse event. • Ultrasound-guided CICC insertion can be performed even in non-ventilated newborns. |
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Data availability
No datasets were generated or analysed during the current study.
Abbreviations
- AE:
-
Adverse events
- CICC:
-
Centrally inserted central catheters
- NICU:
-
Neonatal Intensive Care Unit
- UVC:
-
Umbilical venous catheter
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Dr GB had responsibility for protocol development, patient screening, enrollment, outcome assessment, preliminary data analysis, and writing the manuscript. Drs MN, VD, and CSN participated in the development of the protocol and analytical framework for the study and contributed to the writing of the manuscript. Dr GA conceived the analgosedation protocol and the study itself, supervised the design and execution of the study, performed the final data analyses, and significantly contributed to the writing of the manuscript. All authors read and approved the final manuscript.
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The study was approved by our local Ethics Committee (CEROM), and the parents of each patient provided written informed consent. Number of approval was 2790.
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Communicated by Daniele De Luca
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Barone, G., Natile, M., Nigro, C.S. et al. Prospective case series study on the use of a novel analgosedation protocol for ultrasound-guided catheterization in Neonatal Intensive Care Unit. Eur J Pediatr (2024). https://doi.org/10.1007/s00431-024-05557-9
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DOI: https://doi.org/10.1007/s00431-024-05557-9