Background: Sedoanalgesia secondary iatrogenic withdrawal syndrome (IWS) in paediatric intensive units is frequent and its
assessment is complex. Therapies are heterogeneous, and there is currently no gold standard method for diagnosis. In addition, the
assessment scales validated in children are scarce. This paper aims to identify and describe both the paediatric diagnostic and
assessment tools for the IWS and the treatments for the IWS in critically ill paediatric patients.
Methods: A systematic review was conducted according to the PRISMA guidelines. This review included descriptive and
observational studies published since 2000 that analyzed paediatric scales for the evaluation of the iatrogenic withdrawal syndrome
and its treatments. The eligibility criteria included neonates, newborns, infants, pre-schoolers, and adolescents, up to age 18, who
were admitted to the paediatric intensive care units with continuous infusion of hypnotics and/or opioid analgesics, and who
presented signs or symptoms of deprivation related to withdrawal and prolonged infusion of sedoanalgesia.
Results: Three assessment scales were identified: Withdrawal Assessment Tool-1, Sophia Observation Withdrawal Symptoms,
and Opioid and Benzodiazepine Withdrawal Score. Dexmedetomidine, methadone and clonidine were revealed as options for the
treatment and prevention of the iatrogenic withdrawal syndrome. Finally, the use of phenobarbital suppressed symptoms of
deprivation that are resistant to other drugs.
Conclusions: The reviewed scales facilitate the assessment of the iatrogenic withdrawal syndrome and have a high diagnostic
quality. However, its clinical use is very rare. The treatments identified in this review prevent and effectively treat this syndrome. The
use of validated iatrogenic withdrawal syndrome assessment scales in paediatrics clinical practice facilitates assessment, have a high
diagnostic quality, and should be encouraged, also ensuring nurses’ training in their usage.