Impact of sedation assessment on duration of mechanical ventilation in pediatric intensive care

Abstract

Introduction-Sedation and analgesia should optimize the comfort and safety of children hospitalized In the intensive care unit (ICU).The objective of this study is to evaluate the effects of the implementation of an adaptive sedation algorithm on
the duration of mechanical ventilation.
Methods-: This is a monocentric comparative study of before- and-after practice evaluations,conducted in the paediatric intensive care unit of the Canastel paediatric hospital in Oran.The comparative study was conducted over two periods, the
first from 2014 to 2016 without a sedation assessment protocol and the second from 2017 to 2019 after the introduction of a sedation assessment protocol based on the COMFORT-B scale. All children under 15 years of age who were ventilated and sedated for 24 hours or more were included in the study. For a child we collected demographic data, pathology, severity score, means doses of hypnotics and analgesics, ventilation and length of stay.
Results-We included 71 children in the study "after" implementation of sedation scale and 41Children "before". The conditions for which sedation was indicated were traumatic (32%) and Neurological (30%).The average number of CB assessments per day was 11.8±5 "after". The CB score at the "after" phase was adequate sedation in (71.1%); mild sedation (16.9%) and deep sedation (12%). The duration of mechanical ventilation was 5,9±2,9 days without assessment versus 3,4±1,5 days after assessment. The average doses of hypnotics and analgesics were not significantly different.
Conclusion-The use of a COMFORT B sedation scale allowed a reduction in the duration of mechanical ventilation with no change in the doses of hypnotics and analgesics.