Related Experiment Video

Updated: Jun 12, 2025

Halogenated Agent Delivery in Porcine Model of Acute Respiratory Distress Syndrome via an Intensive Care Unit Type Device
09:36

Halogenated Agent Delivery in Porcine Model of Acute Respiratory Distress Syndrome via an Intensive Care Unit Type Device

Published on: September 24, 2020

2.7K

Protocolized sedation may reduce ventilation and sedation requirements in the pediatric intensive care unit: a

Ambrus Szemere1, Alíz Fazekas2, Anna Réka Sebestyén1,3

  • 1Centre for Translational Medicine, Semmelweis University, Budapest, Hungary.

Clinical and Experimental Pediatrics
|February 20, 2025
PubMed

Insights

Protocolized sedation in pediatric intensive care units (PICU) may shorten mechanical ventilation duration and hospital stays. However, findings require confirmation by randomized controlled trials (RCTs), with a noted increase in unplanned extubations.

Area of Science:

  • Pediatric Critical Care Medicine
  • Pharmacology
  • Evidence-Based Medicine

Background:

  • Sedation management is crucial for mechanically ventilated pediatric patients.
  • Current sedation practices vary, impacting patient outcomes.
  • Protocolized sedation offers a structured approach to optimize care.

Purpose of the Study:

  • To evaluate the effectiveness and safety of protocolized sedation in pediatric intensive care unit (PICU) patients requiring invasive mechanical ventilation (IMV).
  • To synthesize evidence from randomized controlled trials (RCTs) and observational studies on protocol-directed sedation versus conventional regimens.

Main Methods:

  • A systematic literature search was performed across major databases (MEDLINE, CENTRAL, Embase, Web of Science, Scopus) up to October 18, 2023.
  • Included studies compared protocolized sedation with conventional methods in pediatric patients on IMV for over 24 hours.
  • Data from 26 studies involving 15,214 participants were analyzed.

Main Results:

  • Protocolized sedation was associated with a significant reduction in IMV duration (MD=-13.88 hours) and PICU length of stay (MD=-0.64 days).
  • Significant decreases were observed in benzodiazepine duration (MD=-1.28 days) and peak dose (MD=-0.05 mg/kg/hr).
  • A significant increase in the odds of unplanned extubation (OR=1.13) was noted, with no significant findings for other outcomes.

Conclusions:

  • Protocolized sedation may reduce ventilation duration and PICU length of stay, but these benefits were not consistently confirmed by RCTs.
  • A trend towards reduced sedative exposure was observed.
  • Increased odds of unplanned extubation warrant careful consideration and further investigation.

Keywords:
Conscious sedationCritical careDuration of therapyIntensive care unitPediatrics

More Related Videos

Guidelines for Elective Pediatric Fiberoptic Intubation11:19

Guidelines for Elective Pediatric Fiberoptic Intubation

Published on: January 17, 2011

17.5K
In Vitro Method to Control Concentrations of Halogenated Gases in Cultured Alveolar Epithelial Cells04:56

In Vitro Method to Control Concentrations of Halogenated Gases in Cultured Alveolar Epithelial Cells

Published on: October 23, 2018

6.6K

Related Concept Videos

Parenteral Anesthetics: Overview01:24

Parenteral Anesthetics: Overview

Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
111
Inhalational Anesthetics: Overview01:20

Inhalational Anesthetics: Overview

Inhalation anesthetics are drugs that induce general anesthesia upon inhalation. They work by increasing the sensitivity of GABAA receptors or inhibiting NMDA receptors, leading to a decrease in central nervous system activity. The depth of anesthesia can be rapidly adjusted by changing the concentration of the inhaled gas. Some common examples of inhalational anesthetics include volatile liquids like isoflurane, desflurane, sevoflurane and gases like xenon and nitrous oxide. Isoflurane, a...
230
Stages of General Anesthesia01:22

Stages of General Anesthesia

Various sedation levels offer significant advantages in facilitating procedural interventions for patients undergoing medical or invasive surgical procedures. These levels span from anxiolysis to general anesthesia, providing a spectrum of sedative effects to cater to specific patient needs. Anxiolysis reduces anxiety and is achieved through minimal sedation, enabling patients to remain awake and responsive while feeling more at ease during the procedure. This level can benefit minor...
388
Skeletal Muscle Relaxants: Adverse Effects01:21

Skeletal Muscle Relaxants: Adverse Effects

Skeletal muscle relaxants are widely used for muscle paralysis and relieving pain following any muscle injury or stiffness. However, depending on the drug type, they can have adverse effects that range from mild to severe. Usually, nondepolarizing neuromuscular blockers have minimal side effects. For example, drugs like d-tubocurarine, cisatracurium, and rocuronium cause hypotension, whereas drugs like baclofen, when stopped abruptly, can lead to the recurrence of spastic conditions.
Unlike...
346
Mechanical Ventilation III: Noninvasive Ventilation01:23

Mechanical Ventilation III: Noninvasive Ventilation

Noninvasive positive-pressure ventilation (NIPPV), continuous positive airway pressure (CPAP), and bilevel positive airway pressure (BiPAP) are essential methods in respiratory care. These ventilation techniques offer unique benefits for patients with various respiratory conditions, providing adequate support without requiring intubation. Let's explore how each method is crucial in improving patient outcomes and enhancing respiratory therapy.
Noninvasive Positive-Pressure Ventilation...
82
Assessment of Ventilation I: Respiratory Rate01:20

Assessment of Ventilation I: Respiratory Rate

Assessment of Ventilation
A Ventilation assessment is critical for monitoring a patient's health status. Respiration, one of the most accessible vital signs, provides insights into the function of numerous body systems and can indicate serious health issues, such as brainstem injuries from head trauma.
Critical Guidelines for Assessing Ventilation:
1.0K