title: A comparison of gradual sedation levels using the Comfort-B scale and bispectral index in children on mechanical ventilation in the pediatric intensive care unit.
abstract: OBJECTIVE
  Compare the scores resulting from the Comfort-B scale with the bispectral index in children in an intensive care unit.
  
  
  METHODS
  Eleven children between the ages of 1 month and 16 years requiring mechanical ventilation and sedation were simultaneously classified based on the bispectral index and the Comfort-B scale. Their behavior was recorded using digital photography, and the record was later evaluated by three independent evaluators. Agreement tests (Bland-Altman and Kappa) were then performed. The correlation between the two methods (Pearson correlation) was tested.
  
  
  RESULTS
  In total, 35 observations were performed on 11 patients. Based on the Kappa coefficient, the agreement among evaluators ranged from 0.56 to 0.75 (p<0.001). There was a positive and consistent association between the bispectral index and the Comfort-B scale [r=0.424 (p=0.011) to r=0.498 (p=0.002)].
  
  
  CONCLUSIONS
  Due to the strong correlation between the independent evaluators and the consistent correlation between the two methods, the results suggest that the Comfort-B scale is reproducible and useful in classifying the level of sedation in children requiring mechanical ventilation.
authors.affiliation: Hospital das Clínicas de Porto Alegre, Unidade de Terapia Intensiva Pediátrica, Porto AlegreRS, Brasil, Unidade de Terapia Intensiva Pediátrica, Hospital das Clínicas de Porto Alegre - HCPA - Porto Alegre (RS), Brasil.
authors.forename: Cláudia da Costa
authors.initials: Cda C
authors.lastname: Silva
authors.affiliation: Hospital das Clínicas de Porto Alegre, Serviço de Pediatria, Porto AlegreRS, Brasil, Serviço de Pediatria, Hospital das Clínicas de Porto Alegre - HCPA - Porto Alegre (RS), Brasil.
authors.forename: Marta Maria Osório
authors.initials: MM
authors.lastname: Alves
authors.affiliation: Universidade Federal do Rio Grande do Sul, Porto AlegreRS, Brasil, Universidade Federal do Rio Grande do Sul - UFRGS - Porto Alegre (RS), Brasil.
authors.forename: Michel Georges dos Santos
authors.initials: MG
authors.lastname: El Halal
authors.affiliation: Hospital das Clínicas de Porto Alegre, Unidade de Terapia Intensiva Pediátrica, Porto AlegreRS, Brasil, Unidade de Terapia Intensiva Pediátrica, Hospital das Clínicas de Porto Alegre - HCPA - Porto Alegre (RS), Brasil.
authors.forename: Sabrina dos Santos
authors.initials: Sdos S
authors.lastname: Pinheiro
authors.affiliation: Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Departamento de Pediatria, Porto AlegreRS, Brasil, Departamento de Pediatria, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul - UFRGS - Porto Alegre (RS), Brasil.
authors.forename: Paulo Roberto Antonacci
authors.initials: PR
authors.lastname: Carvalho
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D016292:Procedural Sedation / Q000145:classification*; D056805:Consciousness Monitors; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D007223:Infant; D015278:Intensive Care Units, Pediatric; D008297:Male; D010781:Photography; D015203:Reproducibility of Results; D012121:Respiration, Artificial
chemical_list: D006993:Hypnotics and Sedatives