The purposes of this prospective repeated measures study were to: (a) describe the occurrence of withdrawal symptoms with the use of a standardised protocol to slowly taper opioids and benzodiazepines; and (b) to test the predictive validity of an opioid and benzodiazepine withdrawal assessment scoring tool in critically ill infants and young children after prolonged opioid and benzodiazepine therapy. Fifteen children (6 weeks-28 months of age) with complex congenital heart disease and/or respiratory failure who received opioids and benzodiazepines for 4 days or greater were evaluated for withdrawal symptoms using a standardized assessment tool. Thirteen children showed moderate to severe withdrawal symptoms a median 3 days after commencement of tapering. Symptom intensity was not related to prior opioid or benzodiazepine exposure, extracorporeal membrane oxygenation (ECMO) therapy or length of tapering. Children who received fentanyl in addition to morphine more often exhibited signs of withdrawal. This study demonstrated that significant withdrawal symptoms occur in critically ill children even with the use of a standardised assessment tool and tapering management protocol. The predictive validity and utility of the Opioid and Benzodiazepine Withdrawal Score (OBWS) was adequate for clinical use, but areas for further improvement of the tool were identified. Problems with the clinical withdrawal prevention and management guidelines were also identified. More research is needed to establish the optimal methods for prevention and management of iatrogenic opioid and benzodiazepine withdrawal in paediatric critical care.

Linda S Franck

Ita Naughton

Ira Winter

Intensive & critical care nursing

重症和重症监护护理的目的是促进专科护士及其专业同事对重症患者的卓越护理；为研究成果、经验和想法的出版、传播和交流提供一个国际和跨学科论坛；发展和提高对良好的重症监护护理实践至关重要的知识、技能、态度和创造性思维。除了原始论文和重要的初步交流外，该杂志还发表评论、更新和专题文章。文章可以涉及实践的任何部分，包括相关的临床、研究、教育、心理和技术方面。

The journal "Intensive and Critical Care Nursing" aims to promote excellence in the care of critically ill patients by specialized nurses and their professional colleagues. It provides an international and interdisciplinary forum for the publication, dissemination, and exchange of research findings, experiences, and ideas. The journal seeks to develop and enhance the knowledge, skills, attitudes, and creative thinking essential for good practice in intensive and critical care nursing. In addition to original research papers and significant preliminary communications, the journal also publishes commentaries, updates, and thematic articles. Articles may address any aspect of practice, including relevant clinical, research, educational, psychological, and technological issues.

《Intensive and Critical Care Nursing》期刊致力于促进专科护士及其同事对重症患者的卓越护理。它为研究成果、经验和想法的出版、传播和交流提供了一个国际和跨学科的论坛。期刊旨在发展和提升对良好重症监护护理实践至关重要的知识、技能、态度和创造性思维。除了原始研究论文和重要的初步交流外，该杂志还刊登评论、更新和专题文章。文章内容可以涵盖实践的各个方面，包括相关的临床、研究、教育、心理和技术领域。

Category	Quartile
医学	2
医学, 护理	1

Opioid and benzodiazepine withdrawal symptoms in paediatric intensive care patients.

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