Level of discomfort in critically ill paediatric patients and its correlation with sociodemographic and clinical variables, analgosedation and withdrawal syndrome. COSAIP multicentre study (Phase 2).

INTRODUCTION: There are clinical and sociodemographic factors that have an impact on the comfort of the critically ill paediatric patient. The main aim of this study was to determine the level of discomfort of paediatric patients admitted to different national hospitals, and to analyse its correlation with sociodemographic and clinical variables, analgosedation, and withdrawal syndrome. METHODS: An observational, analytical, cross-sectional, and multicentre study was conducted in five Spanish hospitals. The level of analgosedation was assessed once per shift over a 24 h period, using a BIS sensor, and pain with scales adapted to paediatric age population. The intensity of withdrawal syndrome was determined using the Withdrawal Assessment Tool (WAT-1) scale once per shift for 3 days. Discomfort level was simultaneously assessed using COMFORT Behaviour Scale-Spanish version (CBS-S). RESULTS: A total of 261 critically ill paediatric patients with median age of 1.61 years (IQR = 0.35-6.55) were included. An overall discomfort score of 10.79 ±â€¯3.7 was observed during morning compared to 10.31 ±â€¯3.3 during the night. When comparing analgosedation and non-analgosedation groups, statistical differences were found in both shifts (χ2: 45.48; P = .001). At the same time, an association was observed (P < .001) between low discomfort scores and development of withdrawal syndrome development assessed with WAT-1. CONCLUSIONS: As there is a percentage of the studied population with discomfort, specific protocols need to be developed, guided by valuated and clinically tested tools, like the COMFORT Behaviour Scale-Spanish version.

[Level of discomfort in critically ill paediatric patients and its correlation with sociodemographic and clinical variables, analgosedation and withdrawal syndrome. COSAIP multicentre study (Phase 2)]. / Grado de disconfort del paciente crítico pediátrico y correlación con variables sociodemográficas y clínicas, analgosedación y síndrome de abstinencia. Estudio multicéntrico COSAIP (Fase 2).

INTRODUCTION: There are clinical and sociodemographic factors that have an impact on the comfort of the critically ill paediatric patient. The main aim of this study was to determine the level of discomfort of paediatric patients admitted to different national hospitals, and to analyse its correlation with sociodemographic and clinical variables, analgosedation, and withdrawal syndrome. METHODS: An observational, analytical, cross-sectional, and multicentre study was conducted in five Spanish hospitals. The level of analgosedation was assessed once per shift over a 24h period, using a BIS sensor, and pain with scales adapted to paediatric age population. The intensity of withdrawal syndrome was determined using the Withdrawal Assessment Tool (WAT-1) scale once per shift for 3 days. Discomfort level was simultaneous assessed using COMFORT Behaviour Scale-Spanish version (CBS-S). RESULTS: A total of 261 critically ill paediatric patients with median age of 1.61 years (IQR=0.35-6.55) were included. An overall discomfort score of 10.79±3.7 was observed during morning compared to 10.31±3.3 observed during the night. When comparing analgosedation and non-analgosedation groups, statistically differences were found in both shifts (χ2: 45.48; P=.001). At the same time, an association was observed (P<.001) between low discomfort scores and development of withdrawal syndrome development assessed with WAT-1. CONCLUSIONS: As there is a percentage of the studied population with discomfort, specific protocols need to be developed, guided by valuated and clinically tested tools, like the COMFORT Behaviour Scale-Spanish version.

Atención de enfermería a una niña conpancreatitis y relación de ayuda a la madre / Nursing care of a girl with pancreatitis and support to the mother

Introducción. Una niña postoperada de un quiste de colédoco desarrolló una pancreatitis y múltiples complicaciones (ascitis, fístula pancreática, derrrame pleural, paniculitis del tejido graso, necrólisis epidérmica tóxica y trombosis de la vena femoral derecha) durante su estancia en la unidad de cuidados intensivos pediátricos (UCIP).Todo ello generó temor en la niña, afrontamiento familiar inefectivo y dependencia hacia el equipo asistencial. Objetivos. Elaboración de un plan de curas de enfermería individualizado hacia la niña y sus padres. Fomentar la autonomía y participación de la madre respecto a los cuidados de su hija. Conseguir la independencia/desvinculación de la madre del equipo asistencial. Metodología. Aplicación del proceso de atención de enfermería desarrollado por necesidades según el modelo de Virginia Henderson con problemas de colaboración, diagnósticos de enfermería reales y de riesgo e incluyendo la utilización de la taxonomía NANDA. Resultados. Durante la estancia de la niña en nuestra unidad se lograron los objetivos fijados en el plan de curas de enfermería, se redujo la ansiedad inicial de los padres y se incrementó parcialmente la autonomía de la madre en los cuidados de la niña, ayudando a minimizar el síndrome de estrés al traslado. Conclusión. A pesar de que en cualquier UCIP las actividades de enfermería se centran básicamente en problemas de colaboración que requieren una actuación rápida, eficiente y eficaz, consideramos imprescindible la inclusión de los padres en la planificación de los cuidados ante cualquier paciente pediátrico (AU)