J Korean Med Sci.  2007 Aug;22(4):693-697. 10.3346/jkms.2007.22.4.693.

The Efficacy of the COMFORT Scale in Assessing Optimal Sedation in Critically Ill Children Requiring Mechanical Ventilation

• Jin HS
• Yum MS
• Kim SL
• Shin HY
• Lee EH
• Ha EJ
• Hong SJ
• Park SJ

• KMID: 1127089
• DOI: http://doi.org/10.3346/jkms.2007.22.4.693

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.

Keyword

Sedation; Children; Mechanical Ventilation; Withdrawal; Critical Care

MeSH Terms

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

Figure

• 

  Fig. 1 Protocol of pediatric intensive care unit sedation at Asan Medical Center.

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