University Institute of Higher Education and Research in Healthcare, University of Lausanne Faculty of Biology and Medicine, Lausanne, Switzerland.
Department of Woman Mother and Child, Lausanne University Hospital, Lausanne, Switzerland.
BMJ Paediatr Open. 2022 Feb;6(1). doi: 10.1136/bmjpo-2021-001293. Epub 2022 Feb 15.
Inadequate management of pain and sedation in critically ill children can cause unnecessary suffering and agitation, but also delirium and iatrogenic withdrawal. It is, therefore, important to address these four interrelated conditions together. Some clinical practice guidelines (CPGs) are available for the management of pain and sedation, and a few for delirium and iatrogenic withdrawal in the paediatric intensive care unit; none address the four conditions altogether. Critical appraisal of the quality of CPGs is necessary for their recommendations to be adopted into clinical practice. The aim of this systematic review is to identify and appraise the quality of CPGs and recommendations for management of either pain, sedation, delirium and iatrogenic withdrawal.
Researchers will conduct a systematic review in electronic databases (Medline ALL (Ovid), Embase.com, CINAHL with Full Text (EBSCO), JBI EBP Database (Ovid)), guideline repositories and websites of professional societies to identify CPGs published from 2010 to date. They will then combine index and free terms describing CPGs with pain, sedation, delirium and withdrawal. The researchers will include CPGs if they can be applied in the paediatric intensive care population (newborns to 18 years old) and include recommendation(s) for assessment of at least one of the four conditions. Two independent reviewers will screen for eligibility, complete data extraction and quality assessments using the Appraisal of Guidelines for Research and Evaluation (AGREE) II and the AGREE Recommendation Excellence instruments. Researchers will report characteristics, content and recommendations from CPGs in tabulated forms.
Ethical approval is not required for this systematic review. Results will be published in a peer-reviewed journal.
CRD42021274364.
在危重病儿童中，疼痛和镇静管理不足可能导致不必要的痛苦和躁动，还可能导致谵妄和医源性戒断。因此，重要的是要一起解决这四个相互关联的问题。有一些临床实践指南（CPG）可用于管理疼痛和镇静，还有一些用于儿科重症监护病房的谵妄和医源性戒断；没有一个指南涵盖了这四种情况。对 CPG 质量的严格评估对于将其建议纳入临床实践是必要的。本系统评价的目的是确定和评估管理疼痛、镇静、谵妄和医源性戒断的 CPG 和建议的质量。
研究人员将在电子数据库（Medline ALL（Ovid）、Embase.com、CINAHL with Full Text（EBSCO）、JBI EBP Database（Ovid））、指南库和专业协会网站上进行系统评价，以确定 2010 年以来发表的 CPG。然后，他们将使用描述 CPG 的索引和自由词与疼痛、镇静、谵妄和戒断相结合。如果 CPG 可应用于儿科重症监护人群（新生儿至 18 岁），并包括对至少一种四种情况之一的评估建议，则将其纳入研究。两名独立的审查员将根据评估指南的研究和评估（AGREE）II 和 AGREE 推荐卓越工具筛选合格性、完成数据提取和质量评估。研究人员将以表格形式报告 CPG 的特征、内容和建议。
本系统评价不需要伦理批准。结果将发表在同行评议的期刊上。
PROSPERO 注册号：CRD42021274364。
