AUTHOR=Grunauer Michelle , Mikesell Caley , Bustamante Gabriela , Cobo Gissela , Sánchez Sebastián , Román Ana María , Icaza-Freire Andrea P. , Gavilanes Antonio W. D. , Wang Nancy Ewen , The PICU-MIC Research Group , González Jorge López , López-Herce Jesús , Rossetti Emanuele , Fabrizio Chiusolo , Karam Oliver , Saint-Faust Marie , Biban Paolo , Carlassara Silvia , Dessauer Bettina von , Ordenes Nadia , Urízar Fabiola Figueroa , Wegner A Adriana , Canarie Michael , Miller Kathryn , Irazuzta José , Chiriboga Nicolas , Tawfik Daniel , Sourkes Barbara , Wang Nancy Ewen , Vongsachang Hursuong , Tucker Elizabeth W. , Shilkofski Nicole , Wang 王文超 , RN Wenchao , Yuxia RN Zhang , See Lucy Lum Chai , Priscilla Sister , Tekin Recep , Aktar Fesih , Düzkaya Duygu Sönmez , Dursun Oguz , Ongun Ebru Atike , Yilmaz Resul , Yildizdas Dincer , Tekgüç Hakan , Sazonov Vitaliy , Tsoy Timur , Sazonov Vitaliy , Saparov Askhat , Sazonov Vitaliy , Kalmbakh Elizaveta , Grunauer Michelle , Eguiguren Luis , Claudette Killen Harold Briones , Tovilla Yaneth , Gómez Sandra Tania Ventura , Torres Silvio Fabio , Cobarrubias Paul , Dmytriiev Dmytro , Martínez Alejandro , Guzaman Gustavo , Sanabria Rudy , Krupanandan Ravikumar , Ramachandran Bala , Choraria Nirmal , Patel Jignesh , Pooni Puneet A , Gill Karambir Singh , Appiah John Adabie , Anokye Komfo , Heye Tigist Bacha , Argaw Rahel , Demtse Asrat , Admasu Israel Abebe TITLE=Pain Assessment and Management in Pediatric Intensive Care Units Around the World, an International, Multicenter Study JOURNAL=Frontiers in Pediatrics VOLUME=9 YEAR=2021 URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2021.746489 DOI=10.3389/fped.2021.746489 ISSN=2296-2360 ABSTRACT=

The adequate assessment and management of pain remains a challenging task in the Pediatric Intensive Care Unit (PICU). Our goal is to describe how pain is assessed and managed in PICUs around the world and to examine how human and material resources impact achievement of this goal. An international multicenter cross-sectional observational study was designed with the participation of 34 PICUs located in urban, suburban, and rural areas of 18 countries. We evaluated how PICUs around the world assessed and managed pain according to the Initiative for Pediatric Palliative Care recommendations, and how human and material resources impacted achievement of this goal. Data was collected for this study from 2016 to 2018 using questionnaires completed by medical doctors and nurses. In this paper, we focus on the indicators related to how pain is managed and assessed. The average achievement of the goal of pain relief across all centers was 72.2% (SD: 21.1). We found a statistically significant trend of more effective pain management scores, routine assessment, proper documentation, and involvement of pain management experts by increasing country income. While there are efforts being made worldwide to improve the knowledge in pain assessment and management, there is a lack of resources to do so appropriately in low-middle-income countries. There is a mismatch between the existing guidelines and policies, which are mainly designed in high income countries, and the resources available in lower resourced environments.