ArticleAnnals of intensive care2017
Implementation and evaluation of a paediatric nurse-driven sedation protocol in a paediatric intensive care unit.
Article in Annals of intensive care, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 3 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
19 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Ventilation-Weaning Protocols in Children Admitted to Pediatric Intensive Care Units: Systematic Review of Randomized Trials.Pediatric pulmonology · 2025Pooled it
- Impact of Nurse-Driven Analgesia and Sedation Protocols on Medication Exposure and Withdrawal in Critically Ill Children: A Systematic Review.Nursing in critical care · 2025Pooled it
- Assessment and treatment of the withdrawal syndrome in paediatric intensive care units: Systematic review.Medicine · 2020Pooled it
- Pupillometry for pain assessment in noncommunicating children in the pediatric intensive care unit: a prospective accuracy study.European journal of pediatrics · 2026Trial
- Adapting Evidence-Based Practice Guidelines for Sedation, Analgesia, Withdrawal, and Delirium Assessment and Management in Critically Ill Children.Critical care research and practice · 2026Article
- Translation and psychometric properties of the comfort behavioral scale-Persian version.BMC nursing · 2024Article
- Analgesia and sedation in critically ill pediatric patients: an update from the recent guidelines and point of view.European journal of pediatrics · 2023Review
- Article
- Effectiveness, quality and implementation of pain, sedation, delirium, and iatrogenic withdrawal syndrome algorithms in pediatric intensive care: a systematic review and meta-analysis.Frontiers in pediatrics · 2023Review
- Pain and sedation management and monitoring in pediatric intensive care units across Europe: an ESPNIC survey.Critical care (London, England) · 2022Article
- Recommendations for analgesia and sedation in critically ill children admitted to intensive care unit.Journal of anesthesia, analgesia and critical care · 2022Review
- Variations in analgesic, sedation, and delirium management between trauma and non-trauma critically ill children.Pediatric surgery international · 2022Article
- Implementation Science in Pediatric Critical Care - Sedation and Analgesia Practices as a Case Study.Frontiers in pediatrics · 2022Review
- Implementation of a sedation protocol: a quality improvement project to enhance sedation management in the paediatric intensive care unit.BMJ open quality · 2022Article
- Sedation protocols in the pediatric intensive care unit: fact or fiction?Translational pediatrics · 2021Review
- COMFORT Behavior Scale instrument: validity and reliability test for critically ill pediatric patients in Indonesia.Pediatric reports · 2020Article
- Effectiveness of Protocolized Sedation Utilizing the COMFORT-B Scale in Mechanically Ventilated Children in a Pediatric Intensive Care Unit.Journal of pediatric intensive care · 2019Article
- Implementation of a Nurse-Driven Asthma Pathway in the Pediatric Intensive Care Unit.Pediatric quality & safetyArticle
- Standardized Scoring Tool and Weaning Guideline to Reduce Opioids in Critically Ill Neonates.Pediatric quality & safetyArticle
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundOptimal sedation and analgesia is a challenge in paediatric intensive care units (PICU) because of difficulties in scoring systems and specific metabolism inducing tolerance and withdrawal. Excessive sedation is associated with prolonged mechanical ventilation and hospitalisation. Adult and paediatric data suggest that goal-directed sedation algorithms reduce the duration of mechanical ventilation. We implemented a nurse-driven sedation protocol in a PICU and evaluated its impact.
methodsWe conducted a before and after protocol implementation study in a population of children aged 0-18 years who required mechanical ventilation for at least 24 h between January 2013 and March 2015. After the protocol implementation in January 2014, nurses managed analgesia and sedation following an algorithm that included the COMFORT behaviour scale (COMFORT-B). Duration of mechanical ventilation was the primary outcome; secondary outcomes were total doses and duration of medications, PICU length of stay, incidence of ventilator-associated pneumonia, and occurrence of withdrawal symptoms. Pre-post analysis followed with segmented regression analysis of interrupted time series was used to assess the effect of protocol.
resultsA total of 200 children were analysed, including 107 before implementation and 93 children after implementation of the protocol. After implementation of the protocol, the total number of COMFORT-B scores per day of mechanical ventilation significantly increased from 3.9 ± 2.5 times during the pre-implementation period to 6.6 ± 3.5 times during the post-implementation period (p < 10
conclusionsThese results were promising and suggested that implementation of a nurse-driven sedation protocol in a PICU was feasible. Evaluation of sedation and analgesia was better after the protocol implementation; duration of mechanical ventilation and occurrence of withdrawal symptoms tended to be reduced.
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