title: The efficacy of the COMFORT scale in assessing optimal sedation in critically ill children requiring mechanical ventilation.
abstract: Sedation is often necessary to optimize care for critically ill children requiring mechanical ventilation. If too light or too deep, however, sedation can cause significant adverse reactions, making it important to assess the degree of sedation and maintain its optimal level. We evaluated the efficacy of the COMFORT scale in assessing optimal sedation in critically ill children requiring mechanical ventilation. We compared 12 month data in 21 patients (intervention group), for whom we used the pediatric intensive care unit (PICU) sedation protocol of Asan Medical Center (Seoul, Korea) and the COMFORT scale to maintain optimal sedation, with the data in 20 patients (control group) assessed before using the sedation protocol and the COMPORT scale. Compared with the control group, the intervention group showed significant decreases in the total usage of sedatives and analgesics, the duration of mechanical ventilation (11.0 days vs. 12.5 days) and PICU stay (15.0 days vs. 19.5 days), and the development of withdrawal symptoms (1 case vs. 7 cases). The total duration of sedation (8.0 days vs. 11.5 days) also tended to decrease. These findings suggest that application of protocol-based sedation with the COMPORT scale may benefit children requiring mechanical ventilation.
authors.affiliation: Department of Pediatrics, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea.
authors.forename: Hyun Seung
authors.initials: HS
authors.lastname: Jin
authors.forename: Mi Sun
authors.initials: MS
authors.lastname: Yum
authors.forename: Seoung Lan
authors.initials: SL
authors.lastname: Kim
authors.forename: Hye Young
authors.initials: HY
authors.lastname: Shin
authors.forename: Eun Hee
authors.initials: EH
authors.lastname: Lee
authors.forename: Eun Ju
authors.initials: EJ
authors.lastname: Ha
authors.forename: Soo Jong
authors.initials: SJ
authors.lastname: Hong
authors.forename: Seong Jong
authors.initials: SJ
authors.lastname: Park
mesh_terms: D018686:Anesthetics, Intravenous / Q000008:administration & dosage / Q000627:therapeutic use; D002675:Child, Preschool; D016292:Procedural Sedation / Q000379:methods / Q000592:standards; D003422:Critical Care / Q000379:methods* / Q000592:standards; D016638:Critical Illness; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000627:therapeutic use*; D007223:Infant; D007262:Infusions, Intravenous; D007362:Intensive Care Units / Q000706:statistics & numerical data; D007902:Length of Stay; D008297:Male; D008874:Midazolam / Q000008:administration & dosage / Q000627:therapeutic use; D012121:Respiration, Artificial; D016896:Treatment Outcome
chemical_list: D018686:Anesthetics, Intravenous; D006993:Hypnotics and Sedatives; D008874:Midazolam; D005283:Fentanyl