Respiratory Failure Clinical Trial
Official title:
A Randomized, Double-blind, Controlled Trial of Cycling Continuous Sedative Infusions in Critically Ill Pediatric Patients Requiring Mechanical Ventilation
The purpose of this study is to determine if the reduction of the total amount of sedative critically pediatric ill patients receive in the PICU will achieve a significant decrease in mechanical ventilation days and a decrease in the overall length of stay in the PICU and hospital.
Continuous sedative infusions have been associated with longer duration of mechanical
ventilation, longer stay in the intensive care unit (PICU) and total hospital stay. Also,
extended duration of continuous sedative infusions limits the ability to assess for adequate
neurologic function.
There is, however, no published data on the use of daily interruption of continuous sedative
infusions in pediatric patients, nor are there any recommendations from the leading pediatric
critical care groups regarding this issue. Infants and children exposed to noxious stimuli
(endotracheal tube, endotracheal suctioning, mechanical ventilation, indwelling catheters) in
addition to an unknown environment are less likely to cooperate during normal daily
interventions in the PICU. Continuous infusions of benzodiazepines and opioids in addition to
as needed (PRN) bolus doses have been the standard of care in our institution for
mechanically ventilated patients.
The study seeks to determine if reducing the total dose of sedatives, by holding them in a
cyclical manner, will be a safe and effective intervention that will not increase adverse
patient outcomes. This will be achieved by limiting the patient tolerance to the sedatives,
decreasing the body total deposit of sedatives and subsequently decreases awakening time when
patient is ready for extubation.
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