NJCC_05 bwerk v1.indd

Prolonged administration of benzodiazepines and/or opioids to children in a pae diatric intensive care unit (PICU) may induce physiological depen dence and withdrawal symptoms. We reviewed the lit erature for relevant contributions on the nature of these withdrawal symptoms and on availability of valid scoring systems to assess the extent of symptoms in children. Symptoms of benzodiazepine and opioid withdrawal can be classified into three groups: central nervous system (CNS) overstimulation, gastrointestinal dysregulation and autonomic dysfunction. In children, symptoms associated with CNS overstimulation and autonomic dysfunction may overlap after long-term use of benzodiazepines or opioids. Symptoms of gastrointestinal dysfunction in the PICU population have only been described for opioid with drawal. Four scoring systems for use in children have been described. Two of these provided good reliability and validity to determine withdrawal symptoms: the Withdrawal Assessment Tool version 1 (WAT-1) and the Sophia Observation withdrawal Symptoms-scale (SOS).