Optimal sedation of mechanically ventilated pediatric critical care patients

Marx, Celeste M.; Smith, Paul; Lowrie, Lia; Hamlett, Kim W.; Ambuel, Bruce; Yamashita, Toyoko S.; Blumer, Jeffrey L.

doi:10.1097/00003246-199401000-00029

Cited by 137 publications

(72 citation statements)

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“…Although it has been frequently recommended that discomfort in infants admitted to NICUs and the response to analgesic and sedative treatment should be evaluated semi-objectively using validated assessments [10,[15][16][17], there are limitations: some scores are developed mainly for research purposes [15,16], and because most of them are time consuming it is difficult to integrate them into daily routine [16,17]. Experienced and well trained caregivers are able to recognize changes in the newborns' state and can interpret the occurrence of discomfort in this fragile patient population.…”

Section: Discussionmentioning

confidence: 99%

Umgang mit Schmerz und Stress an der Neonatologischen Intensivstation. Eine Evaluation in Österreich

Rohrmeister

Kretzer

Berger

et al. 2003

Wien Klin Wochenschr

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Section: Discussionmentioning

confidence: 99%

Umgang mit Schmerz und Stress an der Neonatologischen Intensivstation. Eine Evaluation in Österreich

Rohrmeister

Kretzer

Berger

et al. 2003

Wien Klin Wochenschr

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“…Of the large number of agents currently used to sedate patients in the PICU, 12 several are known to have a depressant effect on the respiratory drive (e.g., opioids and benzodiazepines). We made an attempt to control for this variable by enrolling patients who required no sedation or were on a continuous propofol infusion at the time of data collection.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of predictors of weaning from mechanical ventilation in pediatric patients

et al. 1997

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“…In children the BIS value correlates well with the level of sedation [8]. For clinical evaluation of the level of sedation the comfort score (CS) was used which has been described elsewhere [9,10]. A score below 17 points reflects deep sedation.…”

Section: Methodsmentioning

confidence: 99%

The effect of neuromuscular blockade on oxygen consumption in sedated and mechanically ventilated pediatric patients after cardiac surgery

2008

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Objective: To measure the effect of intense neuromuscular blockade (NMB) on oxygen consumption (VO 2 ) in deeply sedated and mechanically ventilated children on the first day after complex congenital cardiac surgery. Design: Prospective clinical interventional study. Setting: Pediatric intensive care unit of an university medical centre. Measurements and results: Nine mechanically ventilated and sedated children (weight 2.8-8.7 kg) were included. All children were treated with vasoactive drugs. The level of sedation was quantified using the comfort score, Ramsay score and bispectral index (BIS). The intensity of NMB was quantified using acceleromyography and VO 2 was measured using indirect calorimetry. Analgosedation using various intravenous agents was targeted at a deep level (comfort score \ 18, BIS \ 60 and Ramsay score [ 4). NMB was achieved by intravenous administration of rocuronium. All measurements were conducted before, during and after recovery from a period of intense NMB. Baseline values were VO 2 6.1 ml/(kg min) (SD 1.3), comfort score 13 (SD 0.7), BIS 42.5 (SD 14.2), mean blood pressure 54.0 mmHg (SD 10.5), mean heart rate 129.9 bpm (SD 28.9) and mean core temperature 36.7°C (SD 0.5). There were no significant differences in VO 2 or other parameters between baseline, during NMB and the recovery phase. Conclusion: Neuromuscular blocking agents do not reduce oxygen consumption in deeply sedated and mechanically ventilated children after congenital cardiac surgery.

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Optimal sedation of mechanically ventilated pediatric critical care patients

Cited by 137 publications

References 0 publications

Umgang mit Schmerz und Stress an der Neonatologischen Intensivstation. Eine Evaluation in Österreich

Umgang mit Schmerz und Stress an der Neonatologischen Intensivstation. Eine Evaluation in Österreich

Evaluation of predictors of weaning from mechanical ventilation in pediatric patients

The effect of neuromuscular blockade on oxygen consumption in sedated and mechanically ventilated pediatric patients after cardiac surgery

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