Continuous sedation vs. daily sedation interruption in mechanically-ventilated children
Journal Title: Paediatrica Indonesiana - Year 2016, Vol 56, Issue 1
Abstract
Background A daily sedation interruption (DSI) protocol in ventilated patientsis an effective method of improving sedation management that decreases the duration of mechanical ventilation. In adult patients, it is a safe and effective approach, as well as common practice. For ventilated children,its effectiveness and feasibilityare unknown.Objective To compare continuous sedation and DSI in mechanically-ventilated children with respect todurationof mechanical ventilation, the time needed for patients to awaken, and the frequency of adverse events.Method This randomized, controlled, open-label trial, was performed in a pediatric intensive care unit (PICU). Forty children on mechanical ventilation were included. Patients were randomly assigned to receive either continuous sedation or DSI. The duration of mechanical ventilation was the primary outcome, while the time for patients to awaken on sedative infusion and the frequency of adverse events were secondary outcomes.Results Forty patients were randomized into the continuous sedation protocol (18 subjects) or into the DSI protocol (22 subjects). The median (interquartile range) duration of mechanical ventilation was significantly shorter in the DSI compared to the continuous sedation group [41.50 (30-96) hours vs. 61 (30-132) hours, respectively; (P=0.033)]. The time for patients to awaken was also significantly lower in the DSI than in the continuous sedation group [median (interquartile range): 28 (24-78) vs. 45.5 (25-12) hours, respectively; (P=0.003)]. The frequencies of adverse events were similar in both groups. The severity of illness contributed to outcome variables.Conclusion The duration of mechanical ventilation and the time for patients to awaken are significantly reduced in the DSI group compared to the continuous sedation group.
Authors and Affiliations
Henri Azis, Silvia Triratna, Erial Bahar
Keywords
Related Articles
- EP ID EP446104
- DOI 10.14238/pi56.1.2016.19-23
- Views 58
- Downloads 0
Does malnutrition influence outcome in children undergoing congenital heart surgery in a developing country?
Background Most children undergoing cardiac surgery forcongenital heart disease (CHD) in developing countries aremalnourished. Malnutrition is known as a co-morbidity factorthat might predict and influence outcomes after...
Number of siblings and allergic rhinitis in children
Background Allergic rhinitis is one of the most common chronic diseases of childhood. Recent studies have suggested that having fewer siblings was associated with allergic rhinitis and atopic diseases in children. Previo...
Thyroid hormone profile and PELOD score in children with sepsis
Background Thyroid hormonal dysfunction, also known aseuthyroid sick syndrome or nonthyroidal illness, can be seenin sepsis. There have been few studies on thyroid hormonedysfunction in septic children, as well as on a r...
Upper arm circumference measurement for detecting overweight and obesity in children aged 6-7 years
Background Obesity is a worldwide problem and is associated with increased risk of metabolic syndrome. Nutritional status in children has traditionally been determined by body mass index (BMI) scores, but with limitation...
Early detection of cerebral palsy in high-risk infants: diagnostic value of primitive and developmental reflexes as well as ultrasound
Background The incidence of cerebral palsy (CP) has increased due to better survival of high-risk babies. A simple assessment method is needed for the early detection of CP, which can be performed by general practitioner...