title: Daily interruption of sedation in critically ill children: study protocol for a randomized controlled trial.
abstract: BACKGROUND
  In adult patients who are critically ill and mechanically ventilated, daily interruption of sedation (DSI) is an effective method of improving sedation management, resulting in a decrease of the duration of mechanical ventilation, the length of stay in the intensive care unit (ICU) and the length of stay in the hospital. It is a safe and effective approach and is common practice in adult ICUs. For critically ill children it is unknown if DSI is effective and feasible. The aim of this multicenter randomized controlled trial is to evaluate the safety and efficacy of daily sedation interruption in critically ill children.
  
  
  METHODS
  Children between 0 and 18 years of age who require mechanical ventilation, with an expected duration of at least 48 h and need for sedative infusion, will be included. After enrollment patients will be randomly assigned to DSI in combination with protocolized sedation (intervention group) or protocolized continuous sedation (control group). A sedation protocol that contains an algorithm for increasing and weaning of sedatives and analgesics will be used. The sedative infusion will be restarted if the patient becomes uncomfortable or agitated according to the sedation protocol. The primary endpoint is the number of ventilator-free days at 28 days.
  
  
  BACKGROUND
  NTR2030.
authors: Intensive Care, Erasmus MC - Sophia Children's Hospital, Dr, Molewaterplein 60, 3015 GJ Rotterdam, The Netherlands. n.vet@erasmusmc.nl.
authors: Nienke J
authors: NJ
authors: Vet
authors: Saskia N
authors: SN
authors: de Wildt
authors: Carin W M
authors: CW
authors: Verlaat
authors: Catherijne A J
authors: CA
authors: Knibbe
authors: Miriam G
authors: MG
authors: Mooij
authors: Wim C J
authors: WC
authors: Hop
authors: Joost
authors: J
authors: van Rosmalen
authors: Dick
authors: D
authors: Tibboel
authors: Matthijs
authors: M
authors: de Hoog
mesh_terms: D000293:Adolescent; D000465:Algorithms; D000700:Analgesics / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D002985:Clinical Protocols; D016638:Critical Illness / Q000628:therapy*; D004334:Drug Administration Schedule; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage* / Q000009:adverse effects; D007223:Infant; D007231:Infant, Newborn; D015278:Intensive Care Units, Pediatric; D007902:Length of Stay; D009426:Netherlands; D012107:Research Design; D012121:Respiration, Artificial; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000700:Analgesics; D006993:Hypnotics and Sedatives