412 - Use of Narcotics and Sedatives among Very preterm infants in Neonatal Intensive Units in China: A multi-center Cohort Study

Poster Number: 412
Publication Number: 412.135

Yan Mo, Maternity and Child Health Care of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China (People's Republic); Xinyue Gu, Children's Hospital of Fudan University, Shanghai, Shanghai, China (People's Republic); Dong Li, Dalian woman and children's medical group, Dalian, Liaoning, China (People's Republic); Wenhao Zhou, Children's Hospital, Shanghai, Shanghai, China (People's Republic); Qiufen Wei, 1. Maternity and Child Health Care of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China (People's Republic); Siyuan Jiang, Children's Hospital of Fudan University, Shanghai, Shanghai, China (People's Republic)

Background: Narcotics and sedatives (N/S) are widely used in neonatal intensive units (NICU) for very preterm infants (VPI) undergoing painful and stressful procedures The current status of N/S use in Chinese NICUs has not been previously reported.

Objective: To describe the current use of N/S among VPI in Chinese NICUs, with the emphasis on VPIs on invasive mechanical ventilation (MV), and to investigate the association of exposure to N/S with neonatal outcomes and duration of MV.

Design/Methods: This was a multicenter cohort study involving all VPI born at 24+0-31+6 weeks and admitted to 57 tertiary NICUs in the CHNN in 2019. Descriptive analysis was done to determine the incidence of N/S use as well as the duration. Multivariable logistic regression modelling was used to assess the association between N/S exposure and major neonatal outcomes. Log-linear (Poisson) regression modelling was used to assess the association between the use of N/S and the duration of invasive MV.

Results: A total of 9442 VPIs were included. Among all VPIs, 1566/9442(16.6%) received at least one dose of N/S, 111/9442 (1.2%) only received narcotics, 1301/9442 (13.8%) only received sedatives, and 154/9442 (1.6%) received both narcotics and sedatives during their NICU stay. Of 4172 VPIs who received invasive MV, 1117 (26.8%) received at least one dose of N/S. The N/S use for VPIs varied widely among participating hospitals. The incidence of N/S use among VPIs in children’s hospitals and in perinatal hospitals were significantly different, at 19.0% and 15.9% respectively (PConclusion(s): Use of N/S is conservative in Chinese NICUs and varies among hospitals. There is need for national guidelines one pain/stress management for VPIs in China.
Table 1 Use of narcotics and sedatives among all VPIs in Chinese NICUs by gestational age*Among infants with narcotics and/or sedative use
† P value for trend < 0.0001
VPI: very preterm infant, NICU: neonatal intensive care unit
Table 2 Use of narcotics and sedatives among VPIs during invasive ventilation in Chinese NICUs by gestational age*Among infants with narcotics and/or sedative use
† P value for trend = 0.0975
VPI: very preterm infant, NICU:neonatal intensive care unit