Analgesia Clinical Trial
Official title:
Implementation and Evaluation of a Paediatric Nurse-driven Sedation Protocol in a Paediatric Intensive Care Unit
Management of analgesia and sedation is an integral component of the medical care of a
critically-ill child. Its role is to assure comfort and safety to a patient undergoing
painful cares and technical procedures; it can also be, in particular situations like acute
respiratory distress syndrome or acute brain injury, a full processing treatment.
Sedation involves, most of the time, the association of an opioid and a sedative. The use of
these drugs is difficult in children, because of a specific metabolism, inducing tolerance
and withdrawal in case of prolonged administration.
The COMFORT-BEHAVIOR (COMFORT-B) scale is a validated, simple, reliable and reproducible
score evaluating sedation and analgesia. Sedation scoring systems must be used regularly to
avoid inadequate sedation.
Excessive sedation is associated with poor outcomes like prolonged mechanical ventilation,
longer hospitalisation and more frequent withdrawal symptoms. Adult and paediatric data
suggest that goal-directed sedation algorithms allow a more appropriate adaptation of the
treatment to the patient's need and permit a reduction in the duration of mechanical
ventilation.
The objective was to evaluate the impact of a nurse-driven sedation protocol in a paediatric
intensive care unit on duration of mechanical ventilation, total doses and duration of
medications, Paediatric Intensive Care Unit (PICU) length of stay, incidence of
ventilator-associated-pneumonia and occurrence of withdrawal.
n/a
Time Perspective: Retrospective
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