{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:18:25Z","timestamp":1790813905653,"version":"4.1.0"},"reference-count":35,"publisher":"Georg Thieme Verlag KG","issue":"04","funder":[{"DOI":"10.13039\/100012508","name":"Fore Hadley Foundation","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100012508","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:p>\n            Objective\u2003The aim of this study was to describe the use, duration, and intercenter variation of analgesia and sedation in infants with congenital diaphragmatic hernia (CDH).<\/jats:p><jats:p>\n            Study Design\u2003This is a retrospective analysis of analgesia, sedation, and neuromuscular blockade use in neonates with CDH. Patient data from 2010 to 2016 were abstracted from the Children's Hospitals Neonatal Database and linked to the Pediatric Health Information System. Patients were excluded if they also had non-CDH conditions likely to affect the use of the study medications.<\/jats:p><jats:p>\n            Results\u2003A total of 1,063 patients were identified, 81% survived, and 30% were treated with extracorporeal membrane oxygenation (ECMO). Opioid (99.8%), sedative (93.4%), and neuromuscular blockade (87.9%) use was common. Frequency of use was higher and duration was longer among CDH patients treated with ECMO. Unadjusted duration of use varied 5.6-fold for benzodiazepines (median: 14 days) and 7.4-fold for opioids (median: 16 days). Risk-adjusted duration of use varied among centers, and prolonged use of both opioids and benzodiazepines \u22655 days was associated with increased mortality (p\u2009&lt;\u20090.001) and longer length of stay (p\u2009&lt;\u20090.001). Use of sedation or neuromuscular blockade prior to or after surgery was each associated with increased mortality (p\u2009\u2264\u20090.01).<\/jats:p><jats:p>\n            Conclusion\u2003Opioids, sedatives, and neuromuscular blockade were used commonly in infants with CDH with variable duration across centers. Prolonged combined use \u22655 days is associated with mortality.<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/s-0041-1729877","type":"journal-article","created":{"date-parts":[[2021,5,28]],"date-time":"2021-05-28T00:27:52Z","timestamp":1622161672000},"page":"415-423","source":"Crossref","is-referenced-by-count":11,"title":["Analgesia, Sedation, and Neuromuscular Blockade in Infants with Congenital Diaphragmatic Hernia"],"prefix":"10.1055","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3518-8376","authenticated-orcid":false,"given":"Mark F.","family":"Weems","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics, Le Bonheur Children's Hospital and the University of Tennessee Health Science Center, Memphis, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theresa R.","family":"Grover","sequence":"additional","affiliation":[{"name":"Children's Hospital Colorado and University of Colorado School of Medicine, Aurora, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruth","family":"Seabrook","sequence":"additional","affiliation":[{"name":"Nationwide Children's Hospital, Columbus, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"DiGeronimo","sequence":"additional","affiliation":[{"name":"Seattle Children's Hospital and University of Washington, Seattle, Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason","family":"Gien","sequence":"additional","affiliation":[{"name":"Children's Hospital Colorado and University of Colorado School of Medicine, Aurora, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Keene","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Children's Healthcare of Atlanta at Egleston, Emory University School of Medicine, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalie","family":"Rintoul","sequence":"additional","affiliation":[{"name":"Children's Hospital of Philadelphia and University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John M.","family":"Daniel","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Children's Mercy Hospitals & Clinics, University of Missouri Kansas, Kansas City, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yvette","family":"Johnson","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Cook Children's Hospital, Fort Worth, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yigit","family":"Guner","sequence":"additional","affiliation":[{"name":"Children's Hospital of Orange County and University of California Irvine, Orange, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabella","family":"Zaniletti","sequence":"additional","affiliation":[{"name":"Children's Hospital Association, Lenexa, Kansas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karna","family":"Murthy","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Ann & Robert H Lurie Children's Hospital of Chicago, Feinberg School of Medicine, Northwestern University, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the Children's Hospitals Neonatal Consortium Congenital Diaphragmatic Hernia Focus Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2021,5,27]]},"reference":[{"issue":"14","key":"ref1","doi-asserted-by":"crossref","first-page":"1438","DOI":"10.3109\/14767058.2013.858691","article-title":"Incidence, predictors and outcomes of congenital 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