{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T08:09:14Z","timestamp":1785571754532,"version":"3.56.0"},"reference-count":29,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2021,3,29]],"date-time":"2021-03-29T00:00:00Z","timestamp":1616976000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Analgesics and sedatives are key elements to reduce physiological and psychological stress associated with treatment in paediatric intensive care. Prolonged drug use may induce tolerance and development of iatrogenic withdrawal syndrome (IWS) during the tapering phase. Our primary aim was to describe the prevalence of IWS among critically ill ventilated patients in two Norwegian paediatric intensive care units (PICUs), and secondary to investigate what motivated bedside nurses to administer additional drug doses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Mechanically ventilated patients (n\u00a0=\u00a040) from newborn to eighteen years of age, with continuous infusions of opioids and benzodiazepines for 5\u00a0days or more, were included consecutively from May 2016 to June 2018. By using Withdrawal Assessment Tool\u20101 (WAT\u20101) twice daily we recorded the prevalence of IWS. Additionally, we recorded signs and symptoms that led bedside nurses to administration extra bolus medication.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Peak WAT\u20101 score indicated an IWS prevalence of 95% in this selected group. The first days of the tapering phase were most critical for IWS. The most frequent symptoms triggering administration of additional bolus doses were agitation\/restlessness, and thiopental and propofol were the bolus drugs used most frequently.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>IWS affected 95% of the children having received infusions of opioids and benzodiazepines for 5\u00a0days or more in PICUs without a tapering protocol for these drugs. This calls for implementation and testing of such weaning protocols.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aas.13818","type":"journal-article","created":{"date-parts":[[2021,3,17]],"date-time":"2021-03-17T06:39:48Z","timestamp":1615963188000},"page":"928-935","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Iatrogenic withdrawal syndrome frequently occurs in paediatric intensive care without algorithm for tapering of analgosedation"],"prefix":"10.1111","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6698-9120","authenticated-orcid":false,"given":"Mette","family":"Dokken","sequence":"first","affiliation":[{"name":"Division of Emergencies and Critical Care Paediatric Intensive Care Section Oslo University Hospital \u2010 Rikshospitalet Oslo Norway"},{"name":"Institute of Clinical Medicine University of Oslo Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tone","family":"Rust\u00f8en","sequence":"additional","affiliation":[{"name":"Division of Emergencies and Critical Care Department of Research and Development Oslo University Hospital Oslo Norway"},{"name":"Department of Nursing Science Faculty of Medicine Institute of Health and Society University of Oslo Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lien M.","family":"Diep","sequence":"additional","affiliation":[{"name":"Department of Biostatistic and Epidemiology Oslo University Hospital Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frode E.","family":"Fagermoen","sequence":"additional","affiliation":[{"name":"Division of Emergencies and Critical Care Department of Anesthesiology Oslo University Hospital \u2010 Rikshospitalet Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rakel I.","family":"Huse","sequence":"additional","affiliation":[{"name":"Division of Emergencies and Critical Care Paediatric Intensive Care Section Oslo University Hospital \u2010 Rikshospitalet Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gudny","family":"A. Rosland","sequence":"additional","affiliation":[{"name":"Division of Emergencies and Critical Care Paediatric Intensive Care Section Oslo University Hospital \u2010 Rikshospitalet Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingrid","family":"Egerod","sequence":"additional","affiliation":[{"name":"Intensive Care Department University of Copenhagen Rigshospitalet Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gunnar K.","family":"Bentsen","sequence":"additional","affiliation":[{"name":"Division of Emergencies and Critical Care Department of Anesthesiology Oslo University Hospital \u2010 Rikshospitalet Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,3,29]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1590\/1806-9282.62.06.602"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2009-0489"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-200006000-00079"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(00)02799-9"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1460-9592.2003.01219.x"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000001153"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/apa.12777"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2011.10.003"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0b013e31818c8328"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0b013e31829f5be1"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-009-1487-3"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-016-4344-1"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpt.12787"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000001054"},{"key":"e_1_2_10_16_1","first-page":"238","article-title":"Satisfaction of nurses with the Withdrawal Assessment Tool\u20101 (WAT\u20101)","volume":"39","author":"Suddaby EC","year":"2013","journal-title":"Pediatr Nurs"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000001953"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000002160"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000001719"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2017.08.049"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/ADM.0000000000000197"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000000326"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.medin.2012.02.009"},{"key":"e_1_2_10_24_1","first-page":"5","article-title":"Clonidine for the sedation of critically ill children: a systematic review","volume":"1","author":"Duffett M","year":"2012","journal-title":"J Pediatr Intensive Care"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000018502"},{"key":"e_1_2_10_26_1","first-page":"2157","article-title":"Impact of oral clonidine on duration of opioid and benzodiazepine use in mechanically ventilated children: a randomized, double\u2010blind, Placebo\u2010Controlled Study","volume":"18","author":"Salarian S","year":"2019","journal-title":"Iran J Pharm Res"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000002492"},{"key":"e_1_2_10_28_1","first-page":"1018","article-title":"Update of recommendations for Analgosedation in pediatric intensive care unit","volume":"80","author":"Mondardini MC","year":"2014","journal-title":"Minerva Anestesiol"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2014.11.006"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/jphp.12630"}],"container-title":["Acta Anaesthesiologica Scandinavica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aas.13818","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/aas.13818","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aas.13818","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,29]],"date-time":"2023-08-29T11:35:45Z","timestamp":1693308945000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/aas.13818"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,29]]},"references-count":29,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2021,8]]}},"alternative-id":["10.1111\/aas.13818"],"URL":"https:\/\/doi.org\/10.1111\/aas.13818","archive":["Portico"],"relation":{},"ISSN":["0001-5172","1399-6576"],"issn-type":[{"value":"0001-5172","type":"print"},{"value":"1399-6576","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,29]]},"assertion":[{"value":"2020-11-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-03-06","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-03-29","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}