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

Research involving analgo-sedation is a priority for parents and professionals in paediatric intensive care, and current guidelines are based on low-quality evidence. Future research will require an understanding of current practice and research priorities of healthcare professionals. This survey aimed to identify perceived barriers to research, describe the current UK analgo-sedation practice and assess outcome priorities for future research.

A 26-question web-based survey was emailed to all Paediatric Critical Care Society members (n=1000) in April/May 2021. Responses were analysed either by ‘unit’ or at the individual respondent level. Questions related to four patient categories: ‘infant (< 3 months of age) ‘paediatric’ > 3 months of age, ‘cardiac’ and ‘non-cardiac’.

Two hundred sixteen healthcare professionals responded and responses were available from 100% of the UK paediatric intensive care units (n=29) for all questions. Most units (96%, 28/29) routinely use scoring systems for sedation adequacy but few routinely screen for delirium (24%, 7/29). The most highly prioritised outcome measure was the 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 familiarity with a particular regimen, followed by the perception that parents would not provide consent.

This study provides a snapshot of the UK analgo-sedation practice and highlights the importance of public involvement in planning future trials, as well as consultation work across the spectrum of stakeholder clinicians to maximise the acceptability of study design.