Defining sedation-related adverse events in the pediatric intensive care unit

Grant, Monica J.; Balas, Michele C.; Curley, Martha A. Q.

doi:10.1016/j.hrtlng.2013.02.004

Cited by 25 publications

(15 citation statements)

References 85 publications

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“…of time from placement to tracheostomy removal remain unknown. Possible age related factors include difficulty with pain control, agitation, communication, or concern about airway security and post-extubation failure [7,8]. We hypothesized that burn injury related factors and not age determine the time to removal of a tracheostomy in pediatric burn patients.…”

Section: Introductionmentioning

confidence: 99%

Tracheostomy in pediatric burn patients

Sen

Heather

Palmieri

et al. 2015

Burns

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Section: Introductionmentioning

confidence: 99%

Tracheostomy in pediatric burn patients

Sen

Heather

Palmieri

et al. 2015

Burns

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“…Sedation administration is essential for children on mechanical ventilation in intensive care units (ICUs), and optimal sedation can keep children somnolent and responsive to the environment but untroubled, breathing in synergy with the ventilator and tolerant of or compliant with other therapeutic procedures (Vet et al ., ). Suboptimal sedation administration is associated with a long stay in the hospital or ICU, increasing unplanned extubation rates, weaning failure and a high risk of ventilator‐related pneumonia (Grant et al ., ). Evidence indicates that cumulative sedative doses are related to depression, delirium, delusions, iatrogenic withdrawal and other psychological problems in children (Anand et al ., ; Ista et al ., ).…”

Section: Introductionmentioning

confidence: 97%

The sedation practices of paediatric intensive care unit nurses and the influencing factors in China

Liu

2019

Nursing in Critical Care

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Nurses play a key role in administering sedation to mechanically ventilated children, which impacts children's psychological, physiological and cognitive changes in the paediatric intensive care unit. This study aimed to survey the sedation practices of paediatric intensive care unit nurses on mechanically ventilated children in China and explored the influencing factors. A cross‐sectional survey was conducted based on electronic questionnaires comprised of the Nurse Sedation Practices Scale (Chinese version) in 14 different types of paediatric intensive care units of 11 academic hospitals in China from 15 February to 15 April 2017. A convenience sample of 495 nurses [73·4% response rate, (674)] completed the survey. Seven units applied Ramsay Sedation Scale as a sedative assessment tool. The majority of the nurses used observed behaviours and physiological changes of the ventilated children as indicators to assess the sedation level, and they had a positive attitude and intention, which may influence practice positively, whereas high clinical workload and the lack of communication between the nurses and families might hinder practice. The practice of sedation varied greatly in different regions, and the respondents of the northwest region scored lower. Paediatric nurses in China rarely used a validated paediatric instrument to assess sedation, and most nurses relied on physiological and behavioural cues. The quality of sedation training, nursing workload and regional economic disparity affected the sedation practice. The restricted visiting policy and lack of clearly defined nursing responsibilities around sedation may hinder effective sedation assessment and management. This study found that there was no paediatric‐validated tool popularized in paediatric intensive care units in China and explored influencing factors. We suggest that a validated tool, high‐quality training and hospital's policy, such as visiting regulation, should be promoted to improve the sedation practice.

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“…7 Despite a wide variation in the reported UE rates (0.11-2.27/100 intubated patient days) 8 and the potential need for emergent reintubation, a review on sedation-related adverse events in pediatric patients reported that 14% to 22% of patients experiencing UEs required reintubation after UE. 9 In adults, several studies have demonstrated that the need for reintubation in UE patients was associated with increased pulmonary infectious complications, ventilator days, increased resource utilization, and the need for tracheostomy, as compared with nonreintubation. [10][11][12][13] Although UE is extensively investigated in children, most studies focused on its incidence, risk factors, and prevention.…”

Section: Introductionmentioning

confidence: 99%

“…Despite a wide variation in the reported UE rates (0.11-2.27/100 intubated patient days) 8 and the potential need for emergent reintubation, a review on sedation-related adverse events in pediatric patients reported that 14% to 22% of patients experiencing UEs required reintubation after UE. 9…”

Section: Introductionmentioning

confidence: 99%