A national survey of sedation practice and clinicians’ attitudes regarding sedation-related research in United Kingdom paediatric intensive care units

Purpose: Research involving analgo-sedation is a priority for both parents and professionals in paediatric intensive care, and guidelines are based on low quality evidence. Previous attempts at large-scale trials have faced recruitment challenges. Future research will require an understanding of current practice, research priorities of healthcare professionals and acceptability to parents. This survey aimed to describe current United Kingdom analgo-sedation practice, assess priorities for future research and identify perceived barriers to trials. Methods: A 26-question web-based survey was emailed to all Paediatric Critical Care Society members (n=1000) in April/May 2021. Responses were analysed both by ‘unit’ or at individual respondent level. Questions related to 4 patient categories: ‘neonatal ( 3 months of age, ‘cardiac’ and ‘non-cardiac’. Results: Two hundred and sixteen healthcare professionals answered at least one question and responses were available from 100% of UK paediatric intensive care units (n=29) for all questions. Most units (96%, 28/29) routinely use scoring systems for sedation adequacy and presence of withdrawal (72%, 21/29), but few routinely screen for delirium (24%, 7/29). The most highly prioritised outcome measure for future trials was duration of mechanical ventilation. Respondents were most likely to agree to randomise paediatric general intensive care patients to trials comparing two different alpha agonists, and least likely to randomise neonatal cardiac patients to trials comparing benzodiazepines with alpha agonists. The most common perceived barrier to research was unit preference or familiarity with a particular regimen, followed by the perception that parents would not provide consent. Conclusions: This study provides a snapshot of current United Kingdom analgo-sedation practice, and highlights the importance of parent/patient involvement in planning future trials.