Parental presence in the pediatric intensive care unit reduces postoperative sedative requirements: A retrospective study

BACKGROUND Although critically ill pediatric patients can benefit from the use of sedation, it can cause side effects and even iatrogenic complications. Since pediatric patients cannot adequately express the intensity or location of the pain, discriminating the cause of their irritability and agitation can be more complicated than in adults. Thus, sedation therapy for children requires more careful attention. AIM To evaluate the association of the internal parental care protocol and the reduction in pediatric intensive care unit (PICU) postoperatively. METHODS This retrospective cohort study was carried out in the PICU of the tertiary medical center in Kazakhstan. The internal parental care protocol was developed and implemented by critical care team. During the pandemic, restrictions were also placed on parental presence in the PICU. We compare two groups: During restriction and after return to normal. The level of agitation was evaluated using the Richmond Agitation-Sedation Scale. Univariate and multivariate logistic regression analyses were performed to examine associations of parental care with sedation therapy. RESULTS A total of 289 patients were included in the study. Of them, 167 patients were hospitalized during and 122 after the restrictions of parental care. In multivariate analysis, parental care was associated with lower odds of prescribing diazepam (odds ratio = 0.11, 95% confidence interval: 0.05-0.25), controlling for age, sex, cerebral palsy, and type of surgery. CONCLUSION The results of this study show that parental care was associated only with decreased odds of prescribing sedative drugs, while no differences were observed for analgesics.