A global cross-sectional survey on neonatal analgosedation: unveiling global trends and challenges through latent class analysis DOI Creative Commons
Cristina Arribas, Giacomo Cavallaro, Nunzia Decembrino

et al.

European Journal of Pediatrics, Journal Year: 2025, Volume and Issue: 184(4)

Published: March 12, 2025

Abstract Purpose This study aims to analyze global prescribing patterns for analgosedation in neonates during four critical care scenarios. The research explores existing patterns, their association with geographic and sociodemographic index (SDI), adherence evidence-based practices. Methods Data from a 2024 survey of 924 responses 28 questions were analyzed, focusing on items high variability: premedication intubation (Q17), sedation preterm (Q19) full-term newborns (Q23), perinatal asphyxia (Q26). Latent class analysis (LCA) classified neonatal intensive unit (NICU) prescriptions into assigning participants the most likely class. Demographic variables, including region SDI, compared using chi-square tests assess associations. Results Three distinct emerged each scenario. In intubation, Europe North America predominantly used Class 1, adhering guidelines fentanyl, atropine, muscle relaxants. contrast, 2, standard Asia Latin America-Caribbean, primarily utilized fentanyl midazolam, rare use atropine For newborns, higher-SDI NICUs favored while lower-SDI preferred midazolam or morphine combinations. cases, was leading choice 3, especially Europe. Dexmedetomidine limited, appearing 1 NICUs. Conclusion highlights substantial regional variability analgosedation, influenced by SDI geography. Despite established guidelines, gaps implementation persist. These findings underscore need standardization protocols further long-term safety dexmedetomidine. What is Known: • Previous has demonstrated significant disparities across areas demographic socioeconomic factors. Midazolam remains commonly agent despite evidence suggesting potential neurodevelopmental risks, particularly premature infants. Current regarding analgesia sedation, endotracheal are not consistently implemented, regions characterized lower indices. New: employs Analysis categorize practices three elucidating differences compliance guidelines. Care providers working countries higher Sociodemographic Index (SDI) more adhere practices, such as premedication, than medium medium–high SDI. exposes gap between clinical situation calls development standardized that emphasize safer alternatives reduce associated risks care. underutilized globally its increasing applications, highlighting pharmacokinetic pharmacodynamic before inclusion

Language: Английский

Improved linear growth after routine zinc supplementation in preterm very low birth weight infants DOI Creative Commons

Tina Seidu,

Luc P. Brion, Roy J. Heyne

et al.

Pediatric Research, Journal Year: 2025, Volume and Issue: unknown

Published: March 11, 2025

Abstract Background This study was designed (1) to compare growth, morbidity and mortality in < 33-week gestational age (GA) (very preterm, VPT) or very low birth weight (BW 1500 grams, VLBW) infants before (Epoch-1) after implementing routine enteral zinc (Zn) supplementation (Epoch-2) meet recommendations, (2) assess serum Zn levels associated variables. Methods Single-center prospective cohort of 826 infants. The primary outcome the change (Δ) Z-scores accurate length (Δlength z ), head circumference from discharge home. Results In Epoch-2 vs Epoch-1 Δlength adjusted for confounding variables increased by 0.27 [95% confidence interval (CI) 0.13, 0.42, P 0.001]. However, did not change. decreased with GA postnatal age: ( 0.74 mcg/mL) were observed 51% Retinopathy prematurity (ROP) independently lowest [adjusted odds ratio 0.042 (CI 0.006, 0.306), area under curve=0.928]. Conclusion Routine improved linear growth but prevent occurrence Zn. ROP Implications Multicenter studies are needed whether dosage should be could help ROP. Impact Implementation a more frequent physiologic curve preterm Serum age. Low frequently despite as currently recommended, which suggests need re-evaluate current guidelines this population. among 33 weeks’ gestation age, birthweight, stage bronchopulmonary dysplasia level.

Language: Английский

Citations

0
A global cross-sectional survey on neonatal analgosedation: unveiling global trends and challenges through latent class analysis DOI Creative Commons
Cristina Arribas, Giacomo Cavallaro, Nunzia Decembrino

et al.

European Journal of Pediatrics, Journal Year: 2025, Volume and Issue: 184(4)

Published: March 12, 2025

Abstract Purpose This study aims to analyze global prescribing patterns for analgosedation in neonates during four critical care scenarios. The research explores existing patterns, their association with geographic and sociodemographic index (SDI), adherence evidence-based practices. Methods Data from a 2024 survey of 924 responses 28 questions were analyzed, focusing on items high variability: premedication intubation (Q17), sedation preterm (Q19) full-term newborns (Q23), perinatal asphyxia (Q26). Latent class analysis (LCA) classified neonatal intensive unit (NICU) prescriptions into assigning participants the most likely class. Demographic variables, including region SDI, compared using chi-square tests assess associations. Results Three distinct emerged each scenario. In intubation, Europe North America predominantly used Class 1, adhering guidelines fentanyl, atropine, muscle relaxants. contrast, 2, standard Asia Latin America-Caribbean, primarily utilized fentanyl midazolam, rare use atropine For newborns, higher-SDI NICUs favored while lower-SDI preferred midazolam or morphine combinations. cases, was leading choice 3, especially Europe. Dexmedetomidine limited, appearing 1 NICUs. Conclusion highlights substantial regional variability analgosedation, influenced by SDI geography. Despite established guidelines, gaps implementation persist. These findings underscore need standardization protocols further long-term safety dexmedetomidine. What is Known: • Previous has demonstrated significant disparities across areas demographic socioeconomic factors. Midazolam remains commonly agent despite evidence suggesting potential neurodevelopmental risks, particularly premature infants. Current regarding analgesia sedation, endotracheal are not consistently implemented, regions characterized lower indices. New: employs Analysis categorize practices three elucidating differences compliance guidelines. Care providers working countries higher Sociodemographic Index (SDI) more adhere practices, such as premedication, than medium medium–high SDI. exposes gap between clinical situation calls development standardized that emphasize safer alternatives reduce associated risks care. underutilized globally its increasing applications, highlighting pharmacokinetic pharmacodynamic before inclusion

Language: Английский

Citations

0