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Interventions for the management of Pain and Sedation in Newborns undergoing Therapeutic hypothermia for hypoxic-ischemic encephalopathy (IPSNUT): protocol of a systematic review
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. Univ Hosp, Neonatal Intens Care Unit, Uppsala, Sweden..ORCID iD: 0000-0003-2669-279x
Lund Univ, Dept Pediat, Lund, Sweden.;Skane Univ Hosp, Cochrane Sweden, Res & Dev, Lund, Sweden..
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Perinatal, Neonatal and Pediatric Cardiology Research. Univ Hosp, Neonatal Intens Care Unit, Uppsala, Sweden..ORCID iD: 0000-0001-5955-1278
Örebro Univ, Fac Med & Hlth, Dept Pediat, Örebro, Sweden.;Örebro Univ, Sch Hlth Sci, Fac Med & Hlth, S-70182 Örebro, Sweden..
2022 (English)In: Systematic Reviews, E-ISSN 2046-4053, Vol. 11, no 1, article id 101Article, review/survey (Refereed) Published
Abstract [en]

Background: Clinical research has shown that therapeutic hypothermia after neonatal hypoxic-ischemic injury improves survival without disability. There is no consensus regarding pain relief or sedation during therapeutic hypothermia in newborns; however, therapeutic hypothermia seems to be associated with pain and stress, and adequate analgesia and sedation are central to maximize the effect of therapeutic hypothermia. Pain needs to be adequately managed in all patients, especially the newborn infant due to the potential short- and long-term negative effects of inadequately treated pain in this population. Methods: We will perform a systematic review of pharmacological and non-pharmacological interventions for the management of pain and sedation in newborn infants undergoing therapeutic hypothermia for hypoxic-ischemic encephalopathy. We will include randomized, quasi-randomized controlled trials and observational studies. The use of pharmacological or non-pharmacological interventions will be compared to other pharmacological and or non-pharmacological interventions or no intervention/placebo. The primary outcomes for this review will be analgesia and sedation assessed with validated pain scales, circulatory instability, mortality to discharge, and moderate-to-severe neurodevelopmental disability. We will search the following databases: CINAHL, ClinicalTrials.gov, Cochrane Library, Embase, PubMed, Scopus, and Web of Science. Two independent researchers will screen the records for inclusion, extract data using a data extraction form, and assess the risk of bias in the included trials. Discussion: The result of this review will summarize the knowledge regarding the management of pain and sedation in infants treated with therapeutic hypothermia and potentially provide clinicians with guidance on the effective and safe methods.

Place, publisher, year, edition, pages
Springer Nature Springer Nature, 2022. Vol. 11, no 1, article id 101
Keywords [en]
Therapeutic hypothermia, Neonatal, Asphyxia, Hypoxic-ischemic encephalopathy, Cooling, Pain scale
National Category
Anesthesiology and Intensive Care
Identifiers
URN: urn:nbn:se:uu:diva-476843DOI: 10.1186/s13643-022-01982-9ISI: 000800939200001PubMedID: 35606836OAI: oai:DiVA.org:uu-476843DiVA, id: diva2:1668652
Available from: 2022-06-13 Created: 2022-06-13 Last updated: 2024-01-15Bibliographically approved

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Bäcke, PyrolaThernström Blomqvist, Ylva

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