Quality of sedation during mechanical ventilation.
The aim of the study was to determine the quality of sedation in ventilated patients on a general paediatric intensive care unit (PICU), including those treated with infusions of neuromuscular blocking agents. Twenty-eight ventilated children on a PICU had their level of sedation determined using an arousability scale dependent upon the response to tracheal suction. Observed levels of sedation were then compared to a predetermined desired level of sedation. A total of 81 assessments were performed and 90% were considered satisfactory. Thirty-two of these assessments were performed in 15 children following the temporary discontinuation of infusions of neuromuscular blocking agents; 97% of these assessments were considered satisfactory. A regime of continuous intravenous midazolam and morphine with additional oral sedation using chloral hydrate and antihistamines when required provides a satisfactory level of sedation for the majority of children ventilated on a PICU, including those treated with infusions of neuromuscular blocking agents.
Playfor
S D
SD
Paediatric Intensive Care Unit, Queens Medical Centre, Nottingham NG7 2UH, UK.
Thomas
D A
DA
Choonara
I
I
Jarvis
A
A
D000284:Administration, Oral; D000293:Adolescent; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000627:therapeutic use; D001143:Arousal / Q000187:drug effects*; D002648:Child; D002675:Child, Preschool; D002697:Chloral Hydrate / Q000008:administration & dosage / Q000627:therapeutic use; D003422:Critical Care; D005260:Female; D006634:Histamine H1 Antagonists / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000627:therapeutic use*; D007223:Infant; D007275:Injections, Intravenous; D008297:Male; D008874:Midazolam / Q000008:administration & dosage / Q000627:therapeutic use; D009020:Morphine / Q000008:administration & dosage / Q000627:therapeutic use; D019148:Neuromuscular Blockade; D009466:Neuromuscular Blocking Agents / Q000008:administration & dosage; D010865:Pilot Projects; D012121:Respiration, Artificial; D013396:Suction; D014132:Trachea
D000701:Analgesics, Opioid; D006634:Histamine H1 Antagonists; D006993:Hypnotics and Sedatives; D009466:Neuromuscular Blocking Agents; D002697:Chloral Hydrate; D009020:Morphine; D008874:Midazolam