Association between opioid use during mechanical ventilation in preterm infants and evidence of brain injury: a propensity score-matched cohort study

Article Pediatrics

Early-life exposure to analgesia and 18-month neurodevelopmental outcomes in very preterm infants

Thiviya Selvanathan et al.

Summary: We assessed variability of analgesic use across three tertiary neonatal intensive care units accounting for early-life pain, and determined whether analgesia exposure modifies associations between early-life pain and neurodevelopment.

PEDIATRIC RESEARCH (2023)

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Article Pharmacology & Pharmacy

Drug utilisation in neonatal units in England and Wales: a national cohort study

Asma Al-Turkait et al.

Summary: The purpose of this study was to describe the patterns of drug utilization in neonatal units. The study found that antibiotics and caffeine were the most frequently used drugs in neonatal medicine, regardless of gestational age. Preterm infants were exposed to a high burden of drugs, particularly antibiotics. Changes in drug use patterns reflected the emergence of evidence in some areas, but a number of non-evidence-based drugs continued to be widely used.

EUROPEAN JOURNAL OF CLINICAL PHARMACOLOGY (2022)

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Article Pediatrics

Observational cohort study of changing trends in non-invasive ventilation in very preterm infants and associations with clinical outcomes

Laura Sand et al.

Summary: The analysis of the National Neonatal Research Database from 2010-17 revealed a significant increase in the use of NIV, particularly high-flow nasal cannula, which was associated with reduced odds of death before discharge but increased odds of bronchopulmonary dysplasia (BPD) and other adverse outcomes. The study emphasizes the need for robust clinical evidence to improve outcomes with the use of NIV as initial and ongoing respiratory support, as NIV use is increasing, especially as initial respiratory support.

ARCHIVES OF DISEASE IN CHILDHOOD-FETAL AND NEONATAL EDITION (2022)

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Review Pediatrics

Sedation and analgesia from prolonged pain and stress during mechanical ventilation in preterm infants: is dexmedetomidine an alternative to current practice?

Shalini Ojha et al.

Summary: Mechanical ventilation is uncomfortable and potentially painful. Opioids are commonly used for analgesia, but their effectiveness in mechanically ventilated infants is uncertain. Dexmedetomidine, a selective alpha-2-adrenergic agonist, has been suggested as an alternative with potential benefits. However, there is limited data on its safety and efficacy, particularly in terms of long-term neurodevelopmental effects.

BMJ PAEDIATRICS OPEN (2022)

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Article Pediatrics

Long-term impact of systematic pain and sedation management on cognitive, motor, and behavioral outcomes of extremely preterm infants at preschool age

Philipp Steinbauer et al.

Summary: The study showed that increased neonatal exposure to opiates did not change cognitive and motor outcomes, but may pose a risk factor for autism spectrum disorders and withdrawn behavior at preschool age. Caution is advised in the use of opiates to avoid potential risks.

PEDIATRIC RESEARCH (2021)

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Article Medicine, General & Internal

Assessment of 2-Year Neurodevelopmental Outcomes in Extremely Preterm Infants Receiving Opioids and Benzodiazepines

Mihai Puia-Dumitrescu et al.

Summary: This study investigated the use of opioids and benzodiazepines in extremely preterm infants during neonatal intensive care unit hospitalization, and found that prolonged combined use of these drugs was associated with poorer neurodevelopmental outcomes.

JAMA NETWORK OPEN (2021)

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Article Pediatrics