scholarly journals Tools Are Needed to Promote Sedation Practices for Mechanically Ventilated Patients

2021 ◽  
Vol 8 ◽  
Author(s):  
Tao Wang ◽  
Dongxu Zhou ◽  
Zhongheng Zhang ◽  
Penglin Ma
Keyword(s):  
Standard Care ◽  
Pain Tolerance ◽  
Mechanically Ventilated ◽  
Mechanically Ventilated Patients ◽  
Sedation Protocol ◽  
The Future ◽  
Patient Pain ◽  
Ventilated Patients

Suboptimal sedation practices continue to be frequent, although the updated guidelines for management of pain, agitation, and delirium in mechanically ventilated (MV) patients have been published for several years. Causes of low adherence to the recommended minimal sedation protocol are multifactorial. However, the barriers to translation of these protocols into standard care for MV patients have yet to be analyzed. In our view, it is necessary to develop fresh insights into the interaction between the patients' responses to nociceptive stimuli and individualized regulation of patients' tolerance when using analgesics and sedatives. By better understanding this interaction, development of novel tools to assess patient pain tolerance and to define and predict oversedation or delirium may promote better sedation practices in the future.

A Pediatric Sedation Protocol for Mechanically Ventilated Patients Requires Sustenance Beyond Implementation*

2016 ◽  
Vol 17 (8) ◽  
pp. 721-726 ◽  
Author(s):  
Beryl F. Yaghmai ◽  
Jane L. Di Gennaro ◽  
Gretchen A. Irby ◽  
Kristina H. Deeter ◽  
Jerry J. Zimmerman
Keyword(s):  
Mechanically Ventilated ◽  
Mechanically Ventilated Patients ◽  
Sedation Protocol ◽  
Pediatric Sedation ◽  
Ventilated Patients

Successful implementation of a pediatric sedation protocol for mechanically ventilated patients*

2011 ◽  
Vol 39 (4) ◽  
pp. 683-688 ◽  
Author(s):  
Kristina H. Deeter ◽  
Mary A. King ◽  
Debra Ridling ◽  
Gretchen L. Irby ◽  
Anne M. Lynn ◽  
...  
Keyword(s):  
Successful Implementation ◽  
Mechanically Ventilated ◽  
Mechanically Ventilated Patients ◽  
Sedation Protocol ◽  
Pediatric Sedation ◽  
Ventilated Patients

scholarly journals Effectiveness of Protocolized Sedation Utilizing the COMFORT-B Scale in Mechanically Ventilated Children in a Pediatric Intensive Care Unit

2019 ◽  
Vol 08 (03) ◽  
pp. 156-163 ◽  
Author(s):  
Kantara Saelim ◽  
Shevachut Chavananon ◽  
Kanokpan Ruangnapa ◽  
Pharsai Prasertsan ◽  
Wanaporn Anuntaseree
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Cohort Study ◽  
Intensive Care ◽  
Prospective Cohort ◽  
Pediatric Intensive Care ◽  
Mechanically Ventilated ◽  
Mechanically Ventilated Patients ◽  
Sedation Protocol ◽  
Ventilated Patients

AbstractAppropriate sedation in mechanically ventilated patients is important to facilitate adequate respiratory support and maintain patient safety. However, the optimal sedation protocol for children is unclear. This study assessed the effectiveness of a sedation protocol utilizing the COMFORT-B sedation scale in reducing the duration of mechanical ventilation in children. This was a nonrandomized prospective cohort study compared with a historical control. The prospective cohort study was conducted between November 2015 and August 2016 and included 58 mechanically ventilated patients admitted to the pediatric intensive care unit (PICU). All patients received protocolized sedation utilizing the COMFORT-B scale, which was assessed every 12 hours after intubation by a single assessor. The prospective data were compared with retrospective data of 58 mechanically ventilated patients who received sedation by usual care from November 2014 to August 2015. Fifty percent of 116 patients were male and the mean age was 22 months (interquartile range [IQR]: 6.6–68.4). Patients in the intervention group showed no difference in the duration of mechanical ventilation (median 4.5 [IQR: 2.2–10.5] vs. 5 [IQR: 3–8.8] days). Also, there were no significant differences in the PICU length of stay (LOS; median 7 vs. 7 days, p = 0.59) and hospital LOS (median 18 vs. 14 days, p = 0.14) between the intervention and control groups. The percentages of sedative drugs, including fentanyl, morphine, and midazolam, in each group were not statistically different. The COMFORT-B scale with protocolized sedation in mechanically ventilated pediatric patients in the PICU did not reduce the duration of mechanical ventilation compared with usual care.

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