{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T06:56:46Z","timestamp":1781333806637,"version":"3.54.1"},"reference-count":55,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T00:00:00Z","timestamp":1781222400000},"content-version":"vor","delay-in-days":162,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100002383","name":"King Saud University","doi-asserted-by":"publisher","award":["ORF-2026-1383"],"award-info":[{"award-number":["ORF-2026-1383"]}],"id":[{"id":"10.13039\/501100002383","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Critical Care Research and Practice"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To adapt evidence\u2010based clinical practice guidelines (CPGs) for sedation, analgesia, withdrawal, and delirium assessment and management with a focus on early mobility in critically ill children admitted to a pediatric intensive care unit (PICU).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>The panel included two groups: the guideline adaptation group (GAG), which consisted of two consultant pediatric intensivists, a clinical pharmacist, a senior nurse specialist, and a general pediatrician and a CPG methodologist, and an external review and consultation group, which included five consultant pediatric intensivists, a clinical pharmacist, and two CPG expert physicians. A formal methodology for CPG adaptation was followed and included three phases: set\u2010up, adaptation, and finalization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The provided assessment tools and management algorithms focused on adequacy of sedation and analgesia, medication selection, dosing, initiation, and adjustment for both noninvasive and invasive mechanical ventilation; withdrawal assessment; weaning of sedation and analgesia; withdrawal management; delirium screening; delirium management; as well as early mobility facilitation. Implementation tools included behavioral scoring tool for sedation and pain, Withdrawal Assessment Tool with a management guide, screening score for delirium with a management guide, 3 clinical management algorithms for sedation management, analgesia management, and weaning process.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Based on a systematic adaptation framework and the interdisciplinary and multidisciplinary approach, the present study formulated an adapted CPG with practically applicable implementation tools and management algorithms that might help standardize sedation, analgesia, and withdrawal assessment and management in critically ill children at the PICU. We recommend further studies to clarify the generalizability, impact of its implementation, and practices to overcome potential barriers.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/ccrp\/7830579","type":"journal-article","created":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T06:33:11Z","timestamp":1781332391000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Adapting Evidence\u2010Based Practice Guidelines for Sedation, Analgesia, Withdrawal, and Delirium Assessment and Management in Critically Ill Children"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6530-2403","authenticated-orcid":false,"given":"Muneera","family":"Al-Jelaify","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4378-1276","authenticated-orcid":false,"given":"Gamal","family":"Hasan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4389-9322","authenticated-orcid":false,"given":"Mohamad-Hani","family":"Temsah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7956-9552","authenticated-orcid":false,"given":"Mohammed","family":"Almazyad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Alhaboob","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Majed","family":"Alabdulhafid","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4979-3895","authenticated-orcid":false,"given":"Fahad","family":"Alsohime","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdullah","family":"Alturki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Waleed","family":"Albuali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9278-0985","authenticated-orcid":false,"given":"Alanoud","family":"Almuhareb","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdulaziz","family":"Alsoqati","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0751-8932","authenticated-orcid":false,"given":"Ivan D.","family":"Florez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4097-2317","authenticated-orcid":false,"given":"Yasser S.","family":"Amer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6051-9125","authenticated-orcid":false,"given":"Ayman","family":"Al-Eyadhy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,12]]},"reference":[{"key":"e_1_2_12_1_2","first-page":"95","article-title":"Analgesia and Sedation in Pediatric Intensive Care Unit","volume":"45","author":"Bavdekar S.","year":"1999","journal-title":"Journal of Postgraduate Medicine"},{"key":"e_1_2_12_2_2","unstructured":"Sedation and Analgesia Withdrawal Clinical Guidelines 2018 https:\/\/www.nuh.nhs.uk\/download\/doc\/docm93jijm4n4534.pdf?ver%3d;18113."},{"key":"e_1_2_12_3_2","volume-title":"PICU Clinical Pathway for Sedation\/Analgesia in the Mechanically Ventilated Patient","year":"2017"},{"key":"e_1_2_12_4_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2014-006428"},{"key":"e_1_2_12_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccc.2009.04.001"},{"key":"e_1_2_12_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD009771.pub2"},{"key":"e_1_2_12_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/ccm.0000000000000367"},{"key":"e_1_2_12_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-013-2971-3"},{"key":"e_1_2_12_9_2","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1007\/978-981-97-8903-0_8","article-title":"Weaning Strategy of Mechanical Ventilation in Prolonged Mechanical Ventilation in Children","author":"L\u00f3pez-Fern\u00e1ndez Y. M.","year":"2024","journal-title":"Prolonged and Long-Term Mechanical Ventilation in Children"},{"key":"e_1_2_12_10_2","doi-asserted-by":"crossref","DOI":"10.1136\/bmj-2024-079789","article-title":"Management of Pain and Sedation in the Intensive Care Unit","author":"Boncyk C.","year":"2024","journal-title":"BMJ"},{"key":"e_1_2_12_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/ccm.0b013e318181600d"},{"key":"e_1_2_12_12_2","doi-asserted-by":"publisher","DOI":"10.4103\/sjcp.sjcp_47_23"},{"key":"e_1_2_12_13_2","doi-asserted-by":"publisher","DOI":"10.1186\/s43054-024-00289-9"},{"key":"e_1_2_12_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/jtccm-d-24-00014"},{"key":"e_1_2_12_15_2","doi-asserted-by":"publisher","DOI":"10.1111\/cts.12870"},{"key":"e_1_2_12_16_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1460-9592.2003.00989.x"},{"key":"e_1_2_12_17_2","doi-asserted-by":"publisher","DOI":"10.1097\/ccm.0000000000000326"},{"key":"e_1_2_12_18_2","first-page":"43","article-title":"Pediatric Pain Management: More Opportunities for Better Comfort","volume":"15","author":"Aleyadhy A. A.","year":"2015","journal-title":"Sudanese journal of paediatrics"},{"key":"e_1_2_12_19_2","doi-asserted-by":"publisher","DOI":"10.1093\/jpepsy\/17.1.95"},{"key":"e_1_2_12_20_2","first-page":"427","article-title":"Interrater Reliability of the COMFORT Scale","volume":"32","author":"Bear L. A.","year":"2006","journal-title":"Pediatric Nursing"},{"key":"e_1_2_12_21_2","doi-asserted-by":"publisher","DOI":"10.1097\/pcc.0b013e31818c8328"},{"key":"e_1_2_12_22_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-007-0637-8"},{"key":"e_1_2_12_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pediatrneurol.2023.04.001"},{"key":"e_1_2_12_24_2","doi-asserted-by":"publisher","DOI":"10.1097\/pcc.0000000000003555"},{"key":"e_1_2_12_25_2","doi-asserted-by":"publisher","DOI":"10.1097\/pcc.0000000000002482"},{"key":"e_1_2_12_26_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e318232da75"},{"key":"e_1_2_12_27_2","doi-asserted-by":"publisher","DOI":"10.3390\/children12050633"},{"key":"e_1_2_12_28_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.18399"},{"key":"e_1_2_12_29_2","doi-asserted-by":"publisher","DOI":"10.1097\/pcc.0000000000002729"},{"key":"e_1_2_12_30_2","doi-asserted-by":"publisher","DOI":"10.1111\/jep.12927"},{"key":"e_1_2_12_31_2","doi-asserted-by":"publisher","DOI":"10.1093\/intqhc\/mzi108"},{"key":"e_1_2_12_32_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjqs.2010.046524"},{"key":"e_1_2_12_33_2","doi-asserted-by":"publisher","DOI":"10.26719\/emhj.23.070"},{"key":"e_1_2_12_34_2","doi-asserted-by":"publisher","DOI":"10.1111\/jep.12479"},{"key":"e_1_2_12_35_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjqs.2010.043257"},{"key":"e_1_2_12_36_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-018-0763-4"},{"key":"e_1_2_12_37_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n160"},{"key":"e_1_2_12_38_2","first-page":"145","volume-title":"Seminars in Nuclear Medicine","author":"Brouwers M. C.","year":"2019"},{"key":"e_1_2_12_39_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2020.05.025"},{"key":"e_1_2_12_40_2","doi-asserted-by":"publisher","DOI":"10.1093\/intqhc\/mzy077"},{"key":"e_1_2_12_41_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13613-017-0256-7"},{"key":"e_1_2_12_42_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-016-4344-1"},{"key":"e_1_2_12_43_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.288.20.2561"},{"key":"e_1_2_12_44_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1460-9592.2006.02115.x"},{"key":"e_1_2_12_45_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1460-9592.2007.02325.x"},{"key":"e_1_2_12_46_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2013.07.009"},{"key":"e_1_2_12_47_2","first-page":"325","article-title":"Validation of Sedation Scores in Mechanically Ventilated Children Admitted to a Tertiary Pediatric Intensive Care Unit","volume":"20","author":"Amoretti C. F.","year":"2008","journal-title":"Revista Brasileira de terapia intensiva"},{"key":"e_1_2_12_48_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmn.2010.07.002"},{"key":"e_1_2_12_49_2","doi-asserted-by":"publisher","DOI":"10.1097\/pcc.0b013e3182192d92"},{"key":"e_1_2_12_50_2","article-title":"Pain Assessment in Paediatric Intensive Care: The Italian COMFORT Behaviour Scale","author":"Fagioli D.","year":"2018","journal-title":"Nursing Children and Young People"},{"key":"e_1_2_12_51_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1478-5153.2009.00323.x"},{"key":"e_1_2_12_52_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0039-1678730"},{"key":"e_1_2_12_53_2","doi-asserted-by":"publisher","DOI":"10.1097\/pcc.0000000000002873"},{"key":"e_1_2_12_54_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.26225"},{"key":"e_1_2_12_55_2","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2021.788997"}],"container-title":["Critical Care Research and Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/ccrp\/7830579","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1155\/ccrp\/7830579","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/ccrp\/7830579","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T06:33:14Z","timestamp":1781332394000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/ccrp\/7830579"}},"subtitle":[],"editor":[{"given":"Lorenzo","family":"Schiavoni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":55,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1155\/ccrp\/7830579"],"URL":"https:\/\/doi.org\/10.1155\/ccrp\/7830579","archive":["Portico"],"relation":{},"ISSN":["2090-1305","2090-1313"],"issn-type":[{"value":"2090-1305","type":"print"},{"value":"2090-1313","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2025-11-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-16","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-12","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"7830579"}}