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: Hyun Seung Jin, Mi Sun Yum, Seoung Lan Kim, Hye Young Shin, Eun Hee Lee, Eun Ju Ha, Soo Jong Hong, Seong Jong Park
• Journal: Journal of Korean medical science (J Korean Med Sci) Vol. 22 Issue 4 Pg. 693-7 (Aug 2007) ISSN: 1011-8934 [Print] Korea (South)
• PMID: 17728512 (Publication Type: Clinical Trial, Journal Article)

Chemical References

• Anesthetics, Intravenous
• Hypnotics and Sedatives
• Midazolam
• Fentanyl

Topics

• Anesthetics, Intravenous (administration & dosage, therapeutic use)
• Child, Preschool
• Conscious Sedation (methods, standards)
• Critical Care (methods, standards)
• Critical Illness
• Female
• Fentanyl (administration & dosage, therapeutic use)
• Humans
• Hypnotics and Sedatives (administration & dosage, therapeutic use)
• Infant
• Infusions, Intravenous
• Intensive Care Units (statistics & numerical data)
• Length of Stay
• Male
• Midazolam (administration & dosage, therapeutic use)
• Respiration, Artificial
• Treatment Outcome