A review of key strategies to address the shortage of analgesics and sedatives in pediatric intensive care

Roberta Esteves Vieira de Castro; Miguel Rodríguez-Rubio; Maria Clara de Magalhães-Barbosa; Arnaldo Prata-Barbosa; Jaimee Holbrook; Pradip Kamat; Anne Stormorken

doi:10.3389/fped.2022.895541

A review of key strategies to address the shortage of analgesics and sedatives in pediatric intensive care

Front Pediatr. 2022 Aug 30:10:895541. doi: 10.3389/fped.2022.895541. eCollection 2022.

Authors

Roberta Esteves Vieira de Castro^{1

2

3}, Miguel Rodríguez-Rubio^{4

5}, Maria Clara de Magalhães-Barbosa², Arnaldo Prata-Barbosa², Jaimee Holbrook⁶, Pradip Kamat⁷, Anne Stormorken⁸

Affiliations

¹ Pediatric Intensive Care Unit, Rio de Janeiro State University, Rio de Janeiro, RJ, Brazil.
² Department of Pediatrics, D'Or Institute for Research and Education, Rio de Janeiro, RJ, Brazil.
³ Department of Pediatrics, Souza Marques School of Medicine, Rio de Janeiro, RJ, Brazil.
⁴ Pediatric Intensive Care Department, Hospital Universitario La Paz, Madrid, Spain.
⁵ Department of Pediatrics, Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, Spain.
⁶ Department of Pediatrics, University of Chicago Medicine, Chicago, IL, United States.
⁷ Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, United States.
⁸ Department of Pediatrics, Case Western Reserve University School of Medicine, Cleveland, OH, United States.

Abstract

Importance: Targeted analgosedation is a challenge in critically ill children, and this challenge becomes even more significant with drug shortages.

Observations: Published guidelines inform the provision of analgosedation in critically ill children. This review provides insights into general approaches using these guidelines during drug shortages in Pediatric Intensive Care Units as well as strategies to optimize both pharmacological and non-pharmacological approaches in these situations.

Conclusions and relevance: Considering that drug shortages are a recurrent worldwide problem, this review may guide managing these drugs in critically ill children in situations of scarcity, such as in pandemics or disasters.

Keywords: COVID-19; analgesia; delirium; pediatrics; sedation.

Publication types

Review