Neonatal Abstinence Syndrome Management: A Review of Recent Evidence.
Rev Recent Clin Trials
; 12(4): 226-232, 2017.
Article
em En
| MEDLINE
| ID: mdl-28814260
ABSTRACT
BACKGROUND:
The evaluation and management of infants with neonatal abstinence syndrome (NAS), the constellation of opioid withdrawal specific to newborns, have received renewed attention over the past decade during a new epidemic of opioid use, misuse, abuse, and dependence. Infants with NAS often endure long and costly hospital stays.OBJECTIVE:
We aim to review recent literature on the management and outcomes of infants with, and at risk for, opioid withdrawal.METHODS:
We reviewed articles indexed in PubMed over the past 5 years that examined interventions and/or outcomes related to the management of infants with NAS. Thirty-seven studies were included in our review comprising 8 categories 1) identification of infants at risk for NAS, 2) prenatal factors, 3) evaluation of signs and symptoms, 4) non-pharmacologic care, including rooming-in and breastfeeding, 5) standardization of traditional protocols, 6) pharmacologic management, 7) alternative treatment approaches, and 8) long-term outcomes.RESULTS:
Non-pharmacologic interventions, standardization of traditional protocols, and alternative treatment approaches were all associated with improved outcomes. Lengths of stay were generally lowest in the studies of non-pharmacologic interventions. Patients exposed to buprenorphine in utero tended to have better short-term outcomes than those exposed to methadone. Longer-term outcomes for infants with NAS appear to be worse than those of control groups.CONCLUSION:
The current epidemic necessitates both continued research, and the application of new evidence-based practices in the assessment and treatment of newborns exposed to opioids in utero. Projects focused on non-pharmacologic interventions appear to hold the most promise.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Aleitamento Materno
/
Síndrome de Abstinência Neonatal
/
Gerenciamento Clínico
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Analgésicos Opioides
Tipo de estudo:
Guideline
/
Prognostic_studies
/
Systematic_reviews
Limite:
Humans
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Newborn
Idioma:
En
Ano de publicação:
2017
Tipo de documento:
Article