Sedation/agitation monitoring using a wearable device for ventilated children

Background: Developing continuous and labor-saving sedation/agitation monitoring methods in ventilated children is important to avoid undesirable events such as unplanned extubation. The existing scales are often challenging to use. We therefore aimed to evaluate the feasibility of sedation/agitation monitoring using a wearable device with a built-in accelerometer for ventilated children.Methods: This prospective observational pilot study included children aged 15 years or less, admitted to the pediatric intensive care unit on mechanical ventilation after cardiac catheterization between December 2021 and April 2022. The wearable device with a built-in accelerometer was attached to either of the upper limbs, and accelerations due to upper limb movements were measured for 2 h after admission or until extubation, whichever was earliest. Accelerations were measured at 0.02 s intervals, with the mean acceleration calculated for each 1 min interval. The State Behavioral Scale (SBS) was completed at 1 min intervals, with the SBS score (-1, 0, 1, or 2) compared with the mean acceleration.Results: The study included 20 children with a median age of 12 months. The mean accelerations and SBS scores were positively correlated (Kendall's tau, 0.22; p < 0.001), with an increase in the median (interquartile range) acceleration from an SBS score of -1 through 2, as follows: SBS -1, 0.200 (0.151-0.232) m/s(2); SBS 0, 0.202 (0.190-0.235) m/s(2); SBS, 1, 0.312 (0.236-0.427) m/s(2); SBS 2, 0.455 (0.332-0.517) m/s(2). No adverse events were observed.Conclusions: This study showed that continuous, labor-saving sedation/agitation monitoring of ventilated children was feasible using a wearable device with a built-in accelerometer.