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Pain Assessment and Management in Pediatric Intensive Care Units Around the World, an International, Multicenter

Michelle Grunauer1,2, Caley Mikesell1, Gabriela Bustamante1

  • 1School of Medicine, Universidad San Francisco de Quito USFQ, Quito, Ecuador.

Frontiers in Pediatrics
|November 15, 2021
PubMed

Insights

Effective pain management in Pediatric Intensive Care Units (PICUs) is challenging globally. Higher income countries show better pain assessment and management, highlighting resource disparities worldwide.

Area of Science:

  • Pediatric Intensive Care
  • Pain Management
  • Global Health

Background:

  • Adequate pain assessment and management in Pediatric Intensive Care Units (PICUs) presents significant global challenges.
  • Existing pain management guidelines are often developed in high-income countries, potentially misaligning with resource availability in lower-income settings.

Purpose of the Study:

  • To describe global practices in pain assessment and management within PICUs.
  • To examine the impact of human and material resources on achieving optimal pain relief in PICUs worldwide.

Main Methods:

  • An international, multicenter, cross-sectional observational study involving 34 PICUs across 18 countries.
  • Data collection from 2016-2018 via questionnaires completed by medical doctors and nurses, focusing on pain assessment and management indicators.

Main Results:

  • The average achievement of pain relief goals across all participating centers was 72.2% (SD: 21.1).
  • A significant positive correlation was observed between increasing country income and improved pain management scores, routine assessment, documentation, and expert involvement.
  • Low-middle-income countries face substantial resource limitations for appropriate pain assessment and management.

Conclusions:

  • Global efforts to enhance pain assessment and management knowledge are underway, but resource disparities hinder implementation, particularly in lower-income nations.
  • A significant gap exists between high-income country-centric guidelines and the practical resource realities in less-resourced PICUs worldwide.

Keywords:
painpediatricpediatric critical care unitspediatric palliative careunder resourced settings

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