Narcotics and Sedative Use in Preterm Neonates
Objectives To evaluate patterns of narcotic and sedative use in neonatal intensive care units (NICUs) across Canada using data collected by the Canadian Neonatal Network. Study design We conducted a retrospective observational cohort study of preterm neonates at
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| Veröffentlicht in: | The Journal of pediatrics 2017-01, Vol.180, p.92-98.e1 |
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| container_title | The Journal of pediatrics |
| container_volume | 180 |
| creator | Borenstein-Levin, Liron, MD Synnes, Anne, MDCM, MHSc Grunau, Ruth E., PhD Miller, Steven P., MDCM, MAS Yoon, Eugene W., MSc Shah, Prakesh S., MD, MSc |
| description | Objectives To evaluate patterns of narcotic and sedative use in neonatal intensive care units (NICUs) across Canada using data collected by the Canadian Neonatal Network. Study design We conducted a retrospective observational cohort study of preterm neonates at |
| doi_str_mv | 10.1016/j.jpeds.2016.08.031 |
| format | Article |
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Study design We conducted a retrospective observational cohort study of preterm neonates at <33 weeks' gestation and admitted to a participating Canadian Neonatal Network NICU. The proportion of all neonates who received sedative(s), narcotic(s), or either sedative(s), narcotic(s), or both during their NICU stay was calculated for each year. Because opioids are used for premedication before intubation, only continuous infusions of a narcotic drug were included. Variation in narcotics and sedative usage between sites in 2014 was determined using logistic regression analysis, with adjustment for gestational age, surgery, and mechanical ventilation. Results Of 20 744 neonates, 29% of neonates received a narcotic, a sedative, or both; 23% received a narcotic and 17% a sedative. Although no clinically significant changes in drug exposure were documented during the 5-year period, there were statistically significant differences in narcotic and sedative use between sites, ranging from 3% to 41% for narcotic and 2% to 48% for sedative use (aORs 0.2-5.7 and 0.1-15, respectively, P < .05). Conclusions Exposure to narcotic or sedative agents is highly variable in preterm neonates across Canada despite concerns of adverse outcomes associated with these drugs. The tremendous variation in practice suggests that further research on their current usage, as well as identifying optimal practice procedures is warranted.</description><identifier>ISSN: 0022-3476</identifier><identifier>EISSN: 1097-6833</identifier><identifier>DOI: 10.1016/j.jpeds.2016.08.031</identifier><identifier>PMID: 27614931</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Canada ; Cohort Studies ; Drug Utilization - statistics & numerical data ; Humans ; Hypnotics and Sedatives - therapeutic use ; Infant, Newborn ; Infant, Premature ; Intensive Care Units, Neonatal ; Morphine ; Narcotics ; Narcotics - therapeutic use ; Pediatrics ; Preterm neonates ; Retrospective Studies ; Sedatives</subject><ispartof>The Journal of pediatrics, 2017-01, Vol.180, p.92-98.e1</ispartof><rights>Elsevier Inc.</rights><rights>2016 Elsevier Inc.</rights><rights>Copyright © 2016 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c414t-7bb001494239cec766a6393a48fe7fd4068ed4f5a076de54a70f81433bd98d4f3</citedby><cites>FETCH-LOGICAL-c414t-7bb001494239cec766a6393a48fe7fd4068ed4f5a076de54a70f81433bd98d4f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jpeds.2016.08.031$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>315,781,785,3551,27929,27930,46000</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27614931$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Borenstein-Levin, Liron, MD</creatorcontrib><creatorcontrib>Synnes, Anne, MDCM, MHSc</creatorcontrib><creatorcontrib>Grunau, Ruth E., PhD</creatorcontrib><creatorcontrib>Miller, Steven P., MDCM, MAS</creatorcontrib><creatorcontrib>Yoon, Eugene W., MSc</creatorcontrib><creatorcontrib>Shah, Prakesh S., MD, MSc</creatorcontrib><creatorcontrib>Canadian Neonatal Network Investigators</creatorcontrib><title>Narcotics and Sedative Use in Preterm Neonates</title><title>The Journal of pediatrics</title><addtitle>J Pediatr</addtitle><description>Objectives To evaluate patterns of narcotic and sedative use in neonatal intensive care units (NICUs) across Canada using data collected by the Canadian Neonatal Network. Study design We conducted a retrospective observational cohort study of preterm neonates at <33 weeks' gestation and admitted to a participating Canadian Neonatal Network NICU. The proportion of all neonates who received sedative(s), narcotic(s), or either sedative(s), narcotic(s), or both during their NICU stay was calculated for each year. Because opioids are used for premedication before intubation, only continuous infusions of a narcotic drug were included. Variation in narcotics and sedative usage between sites in 2014 was determined using logistic regression analysis, with adjustment for gestational age, surgery, and mechanical ventilation. Results Of 20 744 neonates, 29% of neonates received a narcotic, a sedative, or both; 23% received a narcotic and 17% a sedative. Although no clinically significant changes in drug exposure were documented during the 5-year period, there were statistically significant differences in narcotic and sedative use between sites, ranging from 3% to 41% for narcotic and 2% to 48% for sedative use (aORs 0.2-5.7 and 0.1-15, respectively, P < .05). Conclusions Exposure to narcotic or sedative agents is highly variable in preterm neonates across Canada despite concerns of adverse outcomes associated with these drugs. The tremendous variation in practice suggests that further research on their current usage, as well as identifying optimal practice procedures is warranted.</description><subject>Canada</subject><subject>Cohort Studies</subject><subject>Drug Utilization - statistics & numerical data</subject><subject>Humans</subject><subject>Hypnotics and Sedatives - therapeutic use</subject><subject>Infant, Newborn</subject><subject>Infant, Premature</subject><subject>Intensive Care Units, Neonatal</subject><subject>Morphine</subject><subject>Narcotics</subject><subject>Narcotics - therapeutic use</subject><subject>Pediatrics</subject><subject>Preterm neonates</subject><subject>Retrospective Studies</subject><subject>Sedatives</subject><issn>0022-3476</issn><issn>1097-6833</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkU1LxDAQhoMoun78AkF69NI6abL5OCiI-AWignoO2WQKqd12TbqC_96sqx68eBqGed95mWcIOaRQUaDipK3aBfpU1bmpQFXA6AaZUNCyFIqxTTIBqOuScSl2yG5KLQBoDrBNdmopKNeMTkh1b6MbxuBSYXtfPKG3Y3jH4iVhEfriMeKIcV7c49DbEdM-2Wpsl_Dgu-6Rl6vL54ub8u7h-vbi_K50nPKxlLMZQE7gNdMOnRTCCqaZ5apB2XgOQqHnzdSCFB6n3EpoFOWMzbxWecD2yPF67yIOb0tMo5mH5LDrbI_DMhmqprVUnIHOUraWujikFLExixjmNn4YCmYFyrTmC5RZgTKgTAaVXUffAcvZHP2v54dMFpyuBZjPfA8YTXIBe4c-RHSj8UP4J-Dsj991oQ_Odq_4gakdlrHPBA01qTZgnla_Wr2KCgZCK80-ARuNjVw</recordid><startdate>20170101</startdate><enddate>20170101</enddate><creator>Borenstein-Levin, Liron, MD</creator><creator>Synnes, Anne, MDCM, MHSc</creator><creator>Grunau, Ruth E., PhD</creator><creator>Miller, Steven P., MDCM, MAS</creator><creator>Yoon, Eugene W., MSc</creator><creator>Shah, Prakesh S., MD, MSc</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20170101</creationdate><title>Narcotics and Sedative Use in Preterm Neonates</title><author>Borenstein-Levin, Liron, MD ; Synnes, Anne, MDCM, MHSc ; Grunau, Ruth E., PhD ; Miller, Steven P., MDCM, MAS ; Yoon, Eugene W., MSc ; Shah, Prakesh S., MD, MSc</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c414t-7bb001494239cec766a6393a48fe7fd4068ed4f5a076de54a70f81433bd98d4f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Canada</topic><topic>Cohort Studies</topic><topic>Drug Utilization - statistics & numerical data</topic><topic>Humans</topic><topic>Hypnotics and Sedatives - therapeutic use</topic><topic>Infant, Newborn</topic><topic>Infant, Premature</topic><topic>Intensive Care Units, Neonatal</topic><topic>Morphine</topic><topic>Narcotics</topic><topic>Narcotics - therapeutic use</topic><topic>Pediatrics</topic><topic>Preterm neonates</topic><topic>Retrospective Studies</topic><topic>Sedatives</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Borenstein-Levin, Liron, MD</creatorcontrib><creatorcontrib>Synnes, Anne, MDCM, MHSc</creatorcontrib><creatorcontrib>Grunau, Ruth E., PhD</creatorcontrib><creatorcontrib>Miller, Steven P., MDCM, MAS</creatorcontrib><creatorcontrib>Yoon, Eugene W., MSc</creatorcontrib><creatorcontrib>Shah, Prakesh S., MD, MSc</creatorcontrib><creatorcontrib>Canadian Neonatal Network Investigators</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of pediatrics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Borenstein-Levin, Liron, MD</au><au>Synnes, Anne, MDCM, MHSc</au><au>Grunau, Ruth E., PhD</au><au>Miller, Steven P., MDCM, MAS</au><au>Yoon, Eugene W., MSc</au><au>Shah, Prakesh S., MD, MSc</au><aucorp>Canadian Neonatal Network Investigators</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Narcotics and Sedative Use in Preterm Neonates</atitle><jtitle>The Journal of pediatrics</jtitle><addtitle>J Pediatr</addtitle><date>2017-01-01</date><risdate>2017</risdate><volume>180</volume><spage>92</spage><epage>98.e1</epage><pages>92-98.e1</pages><issn>0022-3476</issn><eissn>1097-6833</eissn><abstract>Objectives To evaluate patterns of narcotic and sedative use in neonatal intensive care units (NICUs) across Canada using data collected by the Canadian Neonatal Network. Study design We conducted a retrospective observational cohort study of preterm neonates at <33 weeks' gestation and admitted to a participating Canadian Neonatal Network NICU. The proportion of all neonates who received sedative(s), narcotic(s), or either sedative(s), narcotic(s), or both during their NICU stay was calculated for each year. Because opioids are used for premedication before intubation, only continuous infusions of a narcotic drug were included. Variation in narcotics and sedative usage between sites in 2014 was determined using logistic regression analysis, with adjustment for gestational age, surgery, and mechanical ventilation. Results Of 20 744 neonates, 29% of neonates received a narcotic, a sedative, or both; 23% received a narcotic and 17% a sedative. Although no clinically significant changes in drug exposure were documented during the 5-year period, there were statistically significant differences in narcotic and sedative use between sites, ranging from 3% to 41% for narcotic and 2% to 48% for sedative use (aORs 0.2-5.7 and 0.1-15, respectively, P < .05). Conclusions Exposure to narcotic or sedative agents is highly variable in preterm neonates across Canada despite concerns of adverse outcomes associated with these drugs. The tremendous variation in practice suggests that further research on their current usage, as well as identifying optimal practice procedures is warranted.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>27614931</pmid><doi>10.1016/j.jpeds.2016.08.031</doi></addata></record> |
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| subjects | Canada Cohort Studies Drug Utilization - statistics & numerical data Humans Hypnotics and Sedatives - therapeutic use Infant, Newborn Infant, Premature Intensive Care Units, Neonatal Morphine Narcotics Narcotics - therapeutic use Pediatrics Preterm neonates Retrospective Studies Sedatives |
| title | Narcotics and Sedative Use in Preterm Neonates |
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