Publication: Rotación de fármacos sedoanalgésicos en niños críticamente enfermos con sedación prolongada: evaluación de la implantación y eficacia de un protocolo para disminuir el síndrome de abstinencia
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2021-02-15
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Universidad Complutense de Madrid
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Abstract
"Objetivos": el primer objetivo de este estudio ha sido evaluar la factibilidad y dificultad de implementar un protocolo de rotación de medicamentos analgésicos y sedantes en una unidad de cuidados intensivos pediátricos y su cumplimiento. El segundo objetivo ha sido analizar si la utilización de dicho protocolo logra un buen control de la sedoanalgesia de los pacientes pediátricos en estado crítico. El último objetivo ha sido estudiar la incidencia del síndrome de abstinencia, las dosis de fármacos y el tiempo de infusión de sedantes o analgésicos en niños después de la implementación del nuevo protocolo. Pacientes y métodos: estudio prospectivo observacional tras intervención llevado a cabo en una unidad de cuidados intensivos pediátricos (UCIP) de un hospital de atención terciaria entre junio de 2012 y junio de 2016. Los 4 años del estudio se dividieron en dos periodos de dos años cada uno: junio 2012-junio 2014 y julio 2014-junio 2016. Se incluyeron en el estudio los niños entre 1 mes y 16 años de edad ingresados en la UCIP que recibieron una infusión intravenosa continua de medicamentos sedantes o analgésicos durante más de 4 días. Se diseñó un protocolo de rotación de fármacos sedantes y analgésicos. Se monitorizó el nivel de sedación, analgesia y síndrome de abstinencia con escalas validadas. Se estudió la relación entre el cumplimiento del protocolo y la incidencia de síndrome de abstinencia, así como, con otras variables: dosis y duración de los fármacos sedoanalgésicos, días de ingreso y mortalidad...
"Objectives": The first aim of this study was to assess the feasibility and difficulty of implementing a sedative and analgesic drug rotation protocol in a pediatric intensive care unit and its compliance. The second aim was to analyze whether the use of this protocol allows an appropiate control of the sedation and analgesic in pediatric intensive patients. The last aim was to study the incidence of withdrawal syndrome, drug doses and time of sedative or analgesic drug infusion in children after the implementation of the new protocol.Patients and methods: Prospective observational study after intervention. It was carried out in a Pediatric Intensive Care Unit (PICU) of a tertiary care hospital between June 2012 and June 2016. The 4 years of the study were divided in two periods of two years each: June 2012 June 2014 and July 2014 June 2016. All patients between 1 month and 16 years of age admitted to the PICU who received continuous intravenous infusion of sedative or analgesic drugs for more than 4 days were included in the study. A sedative and analgesic drug rotation protocol was designed. The level of sedation, analgesia and withdrawal syndrome were monitored with standardized scales. The relation of compliance with the protocol to the incidence of withdrawal syndrome was studied, as well as to other variables: dose and duration of sedative and analgesic drugs, days of admission and mortality...
"Objectives": The first aim of this study was to assess the feasibility and difficulty of implementing a sedative and analgesic drug rotation protocol in a pediatric intensive care unit and its compliance. The second aim was to analyze whether the use of this protocol allows an appropiate control of the sedation and analgesic in pediatric intensive patients. The last aim was to study the incidence of withdrawal syndrome, drug doses and time of sedative or analgesic drug infusion in children after the implementation of the new protocol.Patients and methods: Prospective observational study after intervention. It was carried out in a Pediatric Intensive Care Unit (PICU) of a tertiary care hospital between June 2012 and June 2016. The 4 years of the study were divided in two periods of two years each: June 2012 June 2014 and July 2014 June 2016. All patients between 1 month and 16 years of age admitted to the PICU who received continuous intravenous infusion of sedative or analgesic drugs for more than 4 days were included in the study. A sedative and analgesic drug rotation protocol was designed. The level of sedation, analgesia and withdrawal syndrome were monitored with standardized scales. The relation of compliance with the protocol to the incidence of withdrawal syndrome was studied, as well as to other variables: dose and duration of sedative and analgesic drugs, days of admission and mortality...
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, leída el 22-10-2020