ABSTRACT
AIM: The main aim of this investigation was to analyse the specificity and sensibility of the COMFORT Behaviour Scale (CBS-S) in assessing grade of pain, sedation, and withdrawal syndrome in paediatric critical care patients. METHOD: An observational, analytical, cross-sectional and multicentre study conducted in Level III Intensive Care Areas of 5 children's university hospitals. Grade of sedation was assessed using the Spanish version of the CBS-S and the Bispectral Index on sedation, once per shift over one day. Grade of withdrawal was determined using the CBS-S and the Withdrawal Assessment Tool-1, once per shift over three days. RESULTS: A total of 261 critically ill paediatric patients with a median age of 5.07 years (P25:0.9-P75:11.7) were included in this study. In terms of the predictive capacity of the CBS-S, it obtained a Receiver Operation Curve of .84 (sensitivity of 81% and specificity of 76%) in relation to pain; .62 (sensitivity of 21% and specificity of 78%) in relation to sedation grade, and .73% (sensitivity of 40% and specificity of 74%) in determining withdrawal syndrome. CONCLUSIONS: The Spanish version of the COMFORT Behaviour Scale could be a useful, sensible and easy scale to assess the degree of pain, sedation and pharmacological withdrawal of critically ill paediatric patients.
Subject(s)
Critical Illness , Substance Withdrawal Syndrome , Child , Child, Preschool , Critical Care , Cross-Sectional Studies , Humans , Intensive Care Units, Pediatric , Pain , Substance Withdrawal Syndrome/diagnosisABSTRACT
Objetivo: El objetivo principal de la investigación fue analizar la especificidad y sensibilidad de la escala COMFORT Behavior Scale-Versión española (CBS-ES) en la determinación del grado de dolor, sedación y síndrome de abstinencia.Método: Se llevó a cabo un estudio observacional, analítico y transversal y multicéntrico en unidades de cuidados intensivos pediátricas de 5 hospitales españoles. Se valoró el grado de sedación del paciente crítico pediátrico de forma simultánea empleando para ello la CBS-ES y registrando los valores del Bispectral Index Sedation, una vez por turno durante un día. El grado de abstinencia se determinó una vez por turno, durante 3 días, empleando de forma simultánea la CBS-ES y la Withdrawal Assessment Tool-1.Resultados: Se incluyeron en el estudio un total de 261 pacientes críticos pediátricos con una mediana de 1,61 años (P25: 0,35-P75: 6,55). Por lo que a la capacidad predictiva de la CBS-ES se refiere se obtuvo un área bajo la curva de 0,84 (sensibilidad del 81% y especificidad del 76%) con relación al dolor; de 0,62 (sensibilidad del 27% y especificidad del 78%) en el caso de la sedación, y de 0,73 (sensibilidad del 40% y especificidad del 74%) en el del síndrome de abstinencia.Conclusiones: Se ha podido contrastar que la CBS-ES podría ser un instrumento sensible, útil y fácil de emplear para valorar el grado de dolor, sedación y síndrome de abstinencia farmacológico del paciente crítico pediátrico.
Aim: The main aim of this investigation was to analyse the specificity and sensibility of the COMFORT Behaviour Scale (CBS-S) in assessing grade of pain, sedation, and withdrawal syndrome in paediatric critical care patients.Method: An observational, analytical, cross-sectional and multicentre study conducted in Level III Intensive Care Areas of 5 children's university hospitals. Grade of sedation was assessed using the Spanish version of the CBS-S and the Bispectral Index on sedation, once per shift over one day. Grade of withdrawal was determined using the CBS-S and the Withdrawal Assessment Tool-1, once per shift over three days.Results: A total of 261 critically ill paediatric patients with a median age of 5.07 years (P25:0.9-P75:11.7) were included in this study. In terms of the predictive capacity of the CBS-S, it obtained a Receiver Operation Curve of .84 (sensitivity of 81% and specificity of 76%) in relation to pain; .62 (sensitivity of 21% and specificity of 78%) in relation to sedation grade, and .73% (sensitivity of 40% and specificity of 74%) in determining withdrawal syndrome.Conclusions: The Spanish version of the COMFORT Behaviour Scale could be a useful, sensible and easy scale to assess the degree of pain, sedation and pharmacological withdrawal of critically ill paediatric patients.
Subject(s)
Humans , Child , Behaviorism , Intensive Care Units, Pediatric , Pain , Substance Withdrawal Syndrome , Substance Withdrawal Syndrome/diagnosis , Cross-Sectional Studies , Nursing , Spain , Critical Care , ChildABSTRACT
Objetivos Determinar los niveles de sedación del paciente crítico pediátrico mediante el Biespectral Index Sensor (BIS) y analizar la relación entre el grado de sedación y las variables sociodemográficas y clínicas del paciente. Métodos Estudio observacional, analítico, transversal y multicéntrico de mayo de 2018 a enero de 2020 desarrollado en 5unidades de cuidados intensivos pediátricas del territorio español. Se registraron como variables sociodemográficas y clínicas el sexo, la edad, motivo de ingreso, si el paciente tenía enfermedad crónica, el tipo y número de fármacos que se le estaban administrando y la duración de la estancia. Además, se anotaron los valores del BIS una vez por turno, mañana y noche, durante 24 h. Resultados Se incluyó en el estudio a un total de 261 pacientes, de los cuales el 53,64% eran del sexo masculino, con una edad mediana de 1,61 años (0,35-6,55). El 70,11% (n=183) estaban analgosedados y monitorizados con el sensor BIS. Se observó una mediana en las puntuaciones globales de BIS de 51,24±14,96 en el turno de mañana y de 50,75±15,55 en el de noche. No se detectó significación estadística al comparar los niveles de BIS y las diversas variables sociodemográficas y clínicas del paciente crítico pediátrico. Conclusiones A pesar de las limitaciones inherentes al sensor BIS, los estudios existentes y el que aquí se presenta muestran que el BIS es un instrumento útil para monitorizar el grado de sedación en el paciente crítico pediátrico. Se requieren más investigaciones que objetiven qué variables relacionadas con el paciente tienen más peso en al grado de analgosedación y que contrasten clínicamente la eficacia de escalas como, por ejemplo, la COMFORT Behavior Scale versión española. (AU)
Aims To determine the grade of sedation in the critically ill paediatric patient using Biespectral Index Sensor (BIS) and to analyse its relationship with sociodemographic and clinical patient variables. Methods Observational, analytical, cross-sectional and multicentre study performed from May 2018 to January 2020 in 5 Spanish paediatric critical care units. Sex, age, reason for admission, presence of a chronic pathology, type and number of drugs and length of stay were the sociodemographic and clinical variables registered. Furthermore, the grade of sedation was assessed using BIS, 11per shift over 24hours. Results A total of 261 paediatric patients, 53.64% of whom were male, with a median age of 1.61 years (0.35-6.55), were included in the study. Of the patients, 70.11% (n=183) were under analgosedation and monitored using the BIS sensor. A median of BIS values of 51.24±14.96 during the morning and 50.75±15.55 during the night were observed. When comparing BIS values and sociodemographic and clinical paediatric variables no statistical significance was detected. Conclusions Despite the limitations of the BIS, investigations and the present study show that BIS could be a useful instrument to assess grade of sedation in critically ill paediatric patients. However, further investigations which determine the sociodemographic and clinical variables involved in the grade of paediatric analgosedation, as well as studies that contrast the efficacy of clinical scales like the COMFORT Behaviour Scale-Spanish version, are required. (AU)
Subject(s)
Humans , Nursing , Pediatrics , Intensive Care Units , Analgesia , Spain , Observational Studies as Topic , Cross-Sectional Studies , Social Conditions , DemographyABSTRACT
AIMS: To determine the grade of sedation in the critically ill paediatric patient using Biespectral Index Sensor (BIS) and to analyse its relationship with sociodemographic and clinical patient variables. METHODS: Observational, analytical, cross-sectional and multicentre study performed from May 2018 to January 2020 in 5 Spanish paediatric critical care units. Sex, age, reason for admission, presence of a chronic pathology, type and number of drugs and length of stay were the sociodemographic and clinical variables registered. Furthermore, the grade of sedation was assessed using BIS, once per shift over 24â¯h. RESULTS: A total of 261 paediatric patients, 53.64% of whom were male, with a median age of 1.61 years (0.35-6.55), were included in the study. Of the patients, 70.11% (nâ¯=â¯183) were under analgosedation and monitored using the BIS sensor. A median of BIS values of 51.24⯱â¯14.96 during the morning and 50.75⯱â¯15.55 during the night were observed. When comparing BIS values and sociodemographic and clinical paediatric variables no statistical significance was detected. CONCLUSIONS: Despite the limitations of the BIS, investigations and the present study show that BIS could be a useful instrument to assess grade of sedation in critically ill paediatric patients. However, further investigations which determine the sociodemographic and clinical variables involved in the grade of paediatric analgosedation, as well as studies that contrast the efficacy of clinical scales like the COMFORT Behaviour Scale-Spanish version, are required.
Subject(s)
Anesthesia , Critical Illness , Child , Cross-Sectional Studies , Hospitalization , Humans , Infant , Intensive Care Units, Pediatric , MaleABSTRACT
AIM: The main aim of this investigation was to analyse the specificity and sensibility of the COMFORT Behaviour Scale (CBS-S) in assessing grade of pain, sedation, and withdrawal syndrome in paediatric critical care patients. METHOD: An observational, analytical, cross-sectional and multicentre study conducted in Level III Intensive Care Areas of 5 children's university hospitals. Grade of sedation was assessed using the Spanish version of the CBS-S and the Bispectral Index on sedation, once per shift over one day. Grade of withdrawal was determined using the CBS-S and the Withdrawal Assessment Tool-1, once per shift over three days. RESULTS: A total of 261 critically ill paediatric patients with a median age of 5.07 years (P25:0.9-P75:11.7) were included in this study. In terms of the predictive capacity of the CBS-S, it obtained a Receiver Operation Curve of .84 (sensitivity of 81% and specificity of 76%) in relation to pain; .62 (sensitivity of 21% and specificity of 78%) in relation to sedation grade, and .73% (sensitivity of 40% and specificity of 74%) in determining withdrawal syndrome. CONCLUSIONS: The Spanish version of the COMFORT Behaviour Scale could be a useful, sensible and easy scale to assess the degree of pain, sedation and pharmacological withdrawal of critically ill paediatric patients.
ABSTRACT
AIMS: To determine the grade of sedation in the critically ill paediatric patient using Biespectral Index Sensor (BIS) and to analyse its relationship with sociodemographic and clinical patient variables. METHODS: Observational, analytical, cross-sectional and multicentre study performed from May 2018 to January 2020 in 5 Spanish paediatric critical care units. Sex, age, reason for admission, presence of a chronic pathology, type and number of drugs and length of stay were the sociodemographic and clinical variables registered. Furthermore, the grade of sedation was assessed using BIS, 11per shift over 24hours. RESULTS: A total of 261 paediatric patients, 53.64% of whom were male, with a median age of 1.61 years (0.35-6.55), were included in the study. Of the patients, 70.11% (n=183) were under analgosedation and monitored using the BIS sensor. A median of BIS values of 51.24±14.96 during the morning and 50.75±15.55 during the night were observed. When comparing BIS values and sociodemographic and clinical paediatric variables no statistical significance was detected. CONCLUSIONS: Despite the limitations of the BIS, investigations and the present study show that BIS could be a useful instrument to assess grade of sedation in critically ill paediatric patients. However, further investigations which determine the sociodemographic and clinical variables involved in the grade of paediatric analgosedation, as well as studies that contrast the efficacy of clinical scales like the COMFORT Behaviour Scale-Spanish version, are required.
