• Laurie A Lee, Stephana J Moss, Dori-Ann Martin, Brianna K Rosgen, Krista Wollny, Elaine Gilfoyle, and Kirsten M Fiest.
• Department of Pediatrics, Cuming School of Medicine, University of Calgary, Calgary, AB, Canada. laurie.lee@ahs.ca.
• Can J Anaesth. 2021 Nov 1; 68 (11): 169517041695-1704.

PurposeTo understand and summarize the breadth of knowledge on comfort-holding in pediatric intensive care units (PICUs).SourcesThis scoping review was conducted using PRISMA methodology. A literature search was conducted in MEDLINE, EMBASE, PsycINFO, CINAHL, and the Cochrane CENTRAL Register of Controlled Trials. Search strategies were developed with a medical librarian and revised through a peer review of electronic search strategies. All databases were searched from inception to 14 April 2020. Only full-text articles available in English were included. All identified articles were reviewed independently and in duplicate using predetermined criteria. All study designs were eligible if they reported on comfort-holding in a PICU. Data were extracted independently and in duplicate.Principal FindingsOf 13,326 studies identified, 13 were included. Comfort-holding was studied in the context of end-of-life care, developmental care, mobilization, and as a unique intervention. Comfort-holding is common during end-of-life care with 77.8% of children held, but rare during acute management (51% of children < three years, < 5% of children ≥ three years). Commonly reported outcomes included child outcomes (e.g., physiologic measurements), safety outcomes (e.g., accidental line removal), parent outcomes (e.g., psychological symptoms), and frequency of holding.ConclusionThere is a paucity of literature on comfort-holding in PICUs. This scoping review identifies significant gaps in the literature, including assessment of child-based outcomes of comfort-holding or safety assessment of comfort-holding, and highlights core outcomes to consider in future evaluations of this intervention including child-based outcomes, parent-based outcomes, and safety of the intervention.© 2021. Canadian Anesthesiologists' Society.

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