• Shawn S Jackson, Jennifer J Lee, William M Jackson, Jerri C Price, Sue R Beers, John W Berkenbosch, Katherine V Biagas, Robert H Dworkin, Constance S Houck, Guohua Li, SmithHeidi A BHABDepartment of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN., Denham S Ward, Kanecia O Zimmerman, CurleyMartha A QMAQSchool of Nursing, University of Pennsylvania, Children's Hospital of Philadelphia, Philadelphia, PA., Christopher M Horvat, David T Huang, Neethi P Pinto, Cynthia F Salorio, Rebeccah Slater, Beth S Slomine, Leanne L West, David Wypij, Keith O Yeates, and Lena S Sun.
• Departments of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, MA.
• Pediatr Crit Care Me. 2024 Apr 1; 25 (4): e193e204e193-e204.

ObjectivesSedation and analgesia for infants and children requiring mechanical ventilation in the PICU is uniquely challenging due to the wide spectrum of ages, developmental stages, and pathophysiological processes encountered. Studies evaluating the safety and efficacy of sedative and analgesic management in pediatric patients have used heterogeneous methodologies. The Sedation Consortium on Endpoints and Procedures for Treatment, Education, and Research (SCEPTER) IV hosted a series of multidisciplinary meetings to establish consensus statements for future clinical study design and implementation as a guide for investigators studying PICU sedation and analgesia.DesignTwenty-five key elements framed as consensus statements were developed in five domains: study design, enrollment, protocol, outcomes and measurement instruments, and future directions.SettingA virtual meeting was held on March 2-3, 2022, followed by an in-person meeting in Washington, DC, on June 15-16, 2022. Subsequent iterative online meetings were held to achieve consensus.SubjectsFifty-one multidisciplinary, international participants from academia, industry, the U.S. Food and Drug Administration, and family members of PICU patients attended the virtual and in-person meetings. Participants were invited based on their background and experience.InterventionsNone.Measurements And Main ResultsCommon themes throughout the SCEPTER IV consensus statements included using coordinated multidisciplinary and interprofessional teams to ensure culturally appropriate study design and diverse patient enrollment, obtaining input from PICU survivors and their families, engaging community members, and using developmentally appropriate and validated instruments for assessments of sedation, pain, iatrogenic withdrawal, and ICU delirium.ConclusionsThese SCEPTER IV consensus statements are comprehensive and may assist investigators in the design, enrollment, implementation, and dissemination of studies involving sedation and analgesia of PICU patients requiring mechanical ventilation. Implementation may strengthen the rigor and reproducibility of research studies on PICU sedation and analgesia and facilitate the synthesis of evidence across studies to improve the safety and quality of care for PICU patients.Copyright © 2024 by the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies.

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