使用COMFORT-B尺度的协议化镇静与机械通风儿童的非协议导向镇静 - 一个开放的标签,随机控制的试验
Pujitha Vallabhaneni1, Daisy Khera2, Bharat Choudhary3
1Department of Pediatrics, All India Institute of Medical Sciences (AIIMS), Jodhpur, India.
Indian journal of pediatrics
|December 7, 2023
概括
使用COMFORT-B尺度的协议化镇静剂显著减少了儿童重症监护病房患者机械通风 (DMV) 的持续时间. 这种方法还降低了镇静剂剂量和相关的不良事件.
科学领域:
- 儿科重症监护室的儿童重症监护室
- 镇静管理 镇静管理
- 机械通风机械通风机械通风
背景情况:
- 重症儿童的机械通风通常需要长时间的镇静.
- 优化镇静方案对于患者的治疗结果和资源利用至关重要.
研究的目的:
- 评估使用COMFORT-B尺度对儿童机械通风 (DMV) 持续时间的影响.
- 为了在协议化和非协议化镇静组之间比较镇静剂剂量和与镇静相关的不良事件.
主要方法:
- 预计机械通风超过24小时的80名儿童被随机分为协议化镇静 (PS) 或非协议化镇静 (NPS) 组.
- 在PS组中,COMFORT行为 (COMFORT-B) 尺度指导镇静.
- 测量的主要结果是机械通风 (DMV) 的持续时间.
主要成果:
- 与NPS组 (8.5天) 相比,PS组 (3.5天) 的DMV明显较低 (p=0.008).
- 累积芬太尼剂量和持续时间在PS组显著减少.
- 与镇静相关的不良事件,包括VAP和意外排泄,在PS下降.
结论:
- 使用COMFORT-B尺度的协议化镇静有效地减少了儿童重症监护室机械通风的持续时间.
- 这种镇静策略还导致更低的镇静剂需求和更少的不良事件.
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