ArticleThe Journal of pediatrics2017
Sedation, Analgesia, and Paralysis during Mechanical Ventilation of Premature Infants.
Article in The Journal of pediatrics, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
34 citing papers in PubMed, 1 synthesis or guideline pooled it, 62 citations in OpenAlex.
- Opioids for newborn infants receiving mechanical ventilation.The Cochrane database of systematic reviews · 2021Pooled it
- Opioid and Methadone Prescribing for Infants with Surgical Management of Congenital Heart Disease.Pediatric cardiology · 2026Observational
- Reframing Risk: Intubation Time Outweighs Tracheostomy in Predicting Neurodevelopment in Severe BPD.The Laryngoscope · 2026Article
- Associations between opioid exposure and brain size among extremely preterm infants.Journal of perinatology : official journal of the California Perinatal Association · 2026Article
- Fentanyl Utilization During Extracorporeal Membrane Oxygenation and Risk of Methadone Treatment Among Pediatric ECMO Survivors.Pediatric surgery international · 2026Article
- Opioid and sedative use in extremely preterm infants receiving mechanical ventilation.Journal of perinatology : official journal of the California Perinatal Association · 2026Article
- Association between early-phase opioid use and outcomes in extremely preterm infants: A nationwide study.Pediatric research · 2025Article
- Cardiorespiratory Stability in Critically Ill Preterm Infants following Dexmedetomidine Initiation.American journal of perinatology · 2025Article
- The Cost of Opioid Use in High-Risk Hospitalized Infants.The Journal of surgical research · 2024Article
- Institutional and Regional Variation in Opioid Prescribing for Hospitalized Infants in the US.JAMA network open · 2024Article
- Association between opioid use during mechanical ventilation in preterm infants and evidence of brain injury: a propensity score-matched cohort study.EClinicalMedicine · 2023Article
- Association of full premedication on tracheal intubation outcomes in the neonatal intensive care unit: an observational cohort study.Journal of perinatology : official journal of the California Perinatal Association · 2023Observational
- Cardiorespiratory Monitoring Data to Predict Respiratory Outcomes in Extremely Preterm Infants.American journal of respiratory and critical care medicine · 2023Article
- Opioid and Methadone Use for Infants With Surgically Treated Necrotizing Enterocolitis.JAMA network open · 2023Article
- Editorial: Pain in infants: pain management practices and the association with outcome.Frontiers in pain research (Lausanne, Switzerland) · 2023Article
- Sedation Prior to Intubation at Birth in Infants with Congenital Diaphragmatic Hernia: An International Survey on Current Practices.Neonatology · 2023Article
- Risk factors for prolonged mechanical ventilation in neonates following gastrointestinal surgery.Translational pediatrics · 2022Article
- Sedation and analgesia from prolonged pain and stress during mechanical ventilation in preterm infants: is dexmedetomidine an alternative to current practice?BMJ paediatrics open · 2022Review
- Frequencies, Modalities, Doses and Duration of Computerized Prescriptions for Sedative, Analgesic, Anesthetic and Paralytic Drugs in Neonates Requiring Intensive Care: A Prospective Pharmacoepidemiologic Cohort Study in 30 French NICUs From 2014 to 2020.Frontiers in pharmacology · 2022Article
- Changes in Physicians' Perceptions and Practices on Neonatal Pain Management Over the Past 20 Years. A Survey Conducted at Two Time-Points.Frontiers in pediatrics · 2021Article
Corrections and comments
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Authors and funding
8 authors at 4 institutions in 1 country.
Funding
Abstract
objectiveTo characterize administration of sedatives, analgesics, and paralytics in a large cohort of mechanically ventilated premature infants. STUDY
designRetrospective cohort study including all infants <1500 g birth weight and <32 weeks gestational age (GA) mechanically ventilated at 348 Pediatrix Medical Group neonatal intensive care units from 1997 to 2012. The primary outcome is the proportion of mechanically ventilated days in which infants were administered drugs of interest. Multivariable logistic regression was used to evaluate the predictors of administration of drugs of interest.
resultsWe identified 85 911 mechanically ventilated infants. Infants received a drug of interest (opioids, benzodiazepines, other sedatives, and paralytics) on 433 587/1 305 413 (33%) of mechanically ventilated infant days. The administration of opioids increased during the study period from 5% of infant days in 1997 to 32% in 2012. The administration of benzodiazepines increased during the study period from 5% of infant days in 1997 to 24% in 2012. Use of paralytics and other drugs remained ≤1% throughout the study period. Predictors of drug administration included younger GA, small for GA status, male sex, presence of a major congenital anomaly, older postnatal age at intubation, exposure to high-frequency ventilation, exposure to inotropes, more recent year of discharge, and neonatal intensive care unit site.
conclusionsAdministration of opioids and benzodiazepines in mechanically ventilated premature infants increased over time. Because infant characteristics were unchanged, site-specific differences in practice likely explain our observations. Increased administration over time is concerning given limited evidence of benefit and potential for harm.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.