Impact of the implementation of a sedoanalgesia protocol in a pediatric intensive care unit

被引:2
作者
Taffarel, Pedro [1 ]
Widmer, Jesica [1 ]
Fiore, Angeles [1 ]
Rodriguez, Ana P. [1 ]
Meregalli, Claudia [1 ]
Baron, Facundo Jorro [1 ,2 ]
机构
[1] Hosp Gen Ninos Pedro Elizalde, Serv Terapia Intensiva, Buenos Aires, Argentina
[2] Inst Efectividad Clin Sanit, Dept Calidad, Seguridad Paciente Gest Clin, Buenos Aires, Argentina
来源
ARCHIVOS ARGENTINOS DE PEDIATRIA | 2023年 / 121卷 / 04期
关键词
clinical protocols; analgesia; mechanic ventilation; pediatric intensive care unit; CRITICALLY-ILL CHILDREN; MECHANICAL VENTILATION; SEDATION; ANALGESIA; DEXMEDETOMIDINE; DELIRIUM; GUIDELINES; MANAGEMENT; INFANTS; PAIN;
D O I
10.5546/aap.2022-02806
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Introduction. Adequate sedation and analgesia is essential in the treatment of patients who require mechanical ventilatory assistance (MVA). The use of protocols and their monitoring is recommended; The results reported on adhesion and impact are disparate. Objectives. To evaluate the impact of the implementation of a sedoanalgesia protocol on the use of benzodiazepines, opioids and evolution in the pediatric intensive care unit (PICU), in patients requiring AVM greater than 72 hours. Methods. Uncontrolled before-after study in the PICU of a pediatric hospital. It was developed in 3 stages: pre-intervention of situational diagnosis (from April to September 2019), intervention and post-intervention of implementation of the sedoanalgesia protocol, education on use and monitoring of adherence and its impact (from October 2019 to October 2021). Results: 99 and 92 patients entered the study in the pre- and post-intervention stages, respectively. They had greater severity, lower age and weight in the pre-intervention period. In the comparison of groups, after adjusting for severity and age, in the post-intervention stage a reduction was reported in the days of continuous infusion opioid use (6 +/- 5.2 vs. 7.6 +/- 5.8; p = 0.018) and the days of use of benzodiazepines in continuous infusion (3.3 +/- 3.5 vs. 7.6 +/- 6.8; p = 0.001). No significant differences were observed in days of AVM and total days of benzodiazepine use. Conclusion. The implementation of a sedoanalgesia protocol made it possible to reduce the use of continuous infusion drugs.
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页数:7
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