Symptoms and Diagnosis of Iatrogenic Withdrawal Syndrome in Critically Ill patients: a scoping review protocol

Introduction: Administration of opioids and sedatives is common for patients within intensive care units (ICU) to facilitate patient comfort and invasive procedures e.g. delivery of mechanical ventilation. Prolonged exposure, high doses and continuous administration put patients at risk of developing IWS. IWS is distressing but despite growing reports of IWS in critically ill adults, uncertainty persists regarding reliable identification. Tools for identifying IWS exist for the paediatric population, yet it remains uncertain whether these tools would be appropriate for use in adults who present with different symptoms. Furthermore, among ICUs with opioid and/or sedative weaning protocols, there is considerable variation in weaning strategies aimed at preventing IWS. Thus, putting patients at further risk of either developing IWS or prolonged exposure to opioids and/or sedatives within ICU Objective: This scoping review aims to identify the symptoms and assessment approaches used to diagnose iatrogenic withdrawal syndrome (IWS) resulting from the discontinuation or weaning of opioids and/or sedatives administration within critically ill patients, and any evidence of their psychometric evaluation. Methods: This review will follow JBI methodology for scoping reviews and adhere to the PRISMA Extension for Scoping Reviews Checklist. We will conduct systematic searches of electronic databases to identify eligible studies, with screening and data charting conducted independently by two reviewers. Study characteristics and extracted data will be charted in a pre-defined template. Results will be described used descriptive statistics, narrative synthesis, and presented as a summary of finding.