Frontiers in Pediatrics (Oct 2021)

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

  • Michelle Grunauer,
  • Michelle Grunauer,
  • Caley Mikesell,
  • Gabriela Bustamante,
  • Gissela Cobo,
  • Sebastián Sánchez,
  • Ana María Román,
  • Andrea P. Icaza-Freire,
  • Antonio W. D. Gavilanes,
  • Nancy Ewen Wang,
  • The PICU-MIC Research Group,
  • Jorge López González,
  • Jesús López-Herce,
  • Emanuele Rossetti,
  • Chiusolo Fabrizio,
  • Oliver Karam,
  • Marie Saint-Faust,
  • Paolo Biban,
  • Silvia Carlassara,
  • Bettina von Dessauer,
  • Nadia Ordenes,
  • Fabiola Figueroa Urízar,
  • Adriana Wegner A,
  • Michael Canarie,
  • Kathryn Miller,
  • José Irazuzta,
  • Nicolas Chiriboga,
  • Daniel Tawfik,
  • Barbara Sourkes,
  • Nancy Ewen Wang,
  • Hursuong Vongsachang,
  • Elizabeth W. Tucker,
  • Nicole Shilkofski,
  • 王文超 Wang,
  • Wenchao RN,
  • Zhang Yuxia RN,
  • Lucy Lum Chai See,
  • Sister Priscilla,
  • Recep Tekin,
  • Fesih Aktar,
  • Duygu Sönmez Düzkaya,
  • Oguz Dursun,
  • Ebru Atike Ongun,
  • Resul Yilmaz,
  • Dincer Yildizdas,
  • Hakan Tekgüç,
  • Vitaliy Sazonov,
  • Timur Tsoy,
  • Vitaliy Sazonov,
  • Askhat Saparov,
  • Vitaliy Sazonov,
  • Elizaveta Kalmbakh,
  • Michelle Grunauer,
  • Luis Eguiguren,
  • Killen Harold Briones Claudette,
  • Yaneth Tovilla,
  • Sandra Tania Ventura Gómez,
  • Silvio Fabio Torres,
  • Paul Cobarrubias,
  • Dmytro Dmytriiev,
  • Alejandro Martínez,
  • Gustavo Guzaman,
  • Rudy Sanabria,
  • Ravikumar Krupanandan,
  • Bala Ramachandran,
  • Nirmal Choraria,
  • Jignesh Patel,
  • Puneet A Pooni,
  • Karambir Singh Gill,
  • John Adabie Appiah,
  • Komfo Anokye,
  • Tigist Bacha Heye,
  • Rahel Argaw,
  • Asrat Demtse,
  • Israel Abebe Admasu

DOI
https://doi.org/10.3389/fped.2021.746489
Journal volume & issue
Vol. 9

Abstract

Read online

The adequate assessment and management of pain remains a challenging task in the Pediatric Intensive Care Unit (PICU). Our goal is to describe how pain is assessed and managed in PICUs around the world and to examine how human and material resources impact achievement of this goal. An international multicenter cross-sectional observational study was designed with the participation of 34 PICUs located in urban, suburban, and rural areas of 18 countries. We evaluated how PICUs around the world assessed and managed pain according to the Initiative for Pediatric Palliative Care recommendations, and how human and material resources impacted achievement of this goal. Data was collected for this study from 2016 to 2018 using questionnaires completed by medical doctors and nurses. In this paper, we focus on the indicators related to how pain is managed and assessed. The average achievement of the goal of pain relief across all centers was 72.2% (SD: 21.1). We found a statistically significant trend of more effective pain management scores, routine assessment, proper documentation, and involvement of pain management experts by increasing country income. While there are efforts being made worldwide to improve the knowledge in pain assessment and management, there is a lack of resources to do so appropriately in low-middle-income countries. There is a mismatch between the existing guidelines and policies, which are mainly designed in high income countries, and the resources available in lower resourced environments.

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