Copyright
©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
Parental presence in the pediatric intensive care unit reduces postoperative sedative requirements: A retrospective study
Vitaliy Sazonov, Alpamys Issanov, Sayazhan Turar, Zaure Tobylbayeva, Olga Mironova, Askhat Saparov, Dmitriy Viderman
Vitaliy Sazonov, Department of Surgery, School of Medicine, Nazarbayev University, Astana 010000, Kazakhstan
Vitaliy Sazonov, Zaure Tobylbayeva, Olga Mironova, Askhat Saparov, Department of Pediatric Anesthesiology and Intensive Care Unit, National Research Center for Maternal and Child Health, “University Medical Center”, Astana 010000, Kazakhstan
Alpamys Issanov, School of Population and Public Health, University of British Columbia, Vancouver BCV6T1Z3, British Columbia, Canada
Sayazhan Turar, Department of Medicine, School of Medicine, Nazarbayev University, Astana 010000, Kazakhstan
Dmitriy Viderman, Department of Anesthesiology, Intensive Care, and Pain Medicine, National Research Oncology Center, Astana 010000, Kazakhstan
Co-first authors: Vitaliy Sazonov and Alpamys Issanov.
Author contributions: Issanov A and Sazonov V participated in the review and editing and made crucial and indispensable contributions towards the completion of the project, they contributed equally to this article, they are the co-first authors of this manuscript; Sazonov V, Issanov A, and Viderman D designed the research study; Issanov A was responsible for developing the methodology; Turar S, Tobylbayeva Z, Mironova O, and Saparov A participated in the formal analysis and investigation; Turar S was responsible for literature review, Sazonov V wrote the original draft; and all authors thoroughly reviewed and endorsed the final manuscript.
Institutional review board statement: This study was approved by the Medical Ethics Committee of the Local Bioethics Commission of the corporate foundation “University Medical Center”, approval December 11, 2023 No. 9.
Informed consent statement: Due to the retrospective nature of this study, the requirement for informed consent was waived. All patient data were deidentified to maintain confidentiality in accordance with HIPAA regulations.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The original contributions presented in the study are included in the article/supplementary material, further inquiries can be directed to the corresponding author.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Vitaliy Sazonov, MD, Assistant Professor, Department of Surgery, School of Medicine, Nazarbayev University, Kerei-Zhanibek Street. 5/1, Astana 010000, Kazakhstan.
vitaliy.sazonov@nu.edu.kz
Received: October 7, 2024
Revised: February 12, 2025
Accepted: February 27, 2025
Published online: June 9, 2025
Processing time: 162 Days and 1.1 Hours
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.
Core Tip: Parental presence in the pediatric intensive care unit (PICU) may serve as a nonpharmacologic intervention to reduce the need for sedation in postoperative pediatric patients. This retrospective cohort study shows that children whose parents were present during their PICU stay were less likely to receive diazepam, suggesting that parental care may help reduce anxiety and agitation. The findings highlight the therapeutic role of family-centered care in the PICU and emphasize the need for further research on structured parental involvement as a strategy to optimize sedation practices and improve patient recovery.
