Effect of sequential sedation and analgesia in preventing delirium and withdrawal symptoms in children after ventilator weaning

YANG Wen-Hai; LAI Zhi-Jun; LI Yan; MA Ke-Ze

doi:10.7499/j.issn.1008-8830.2202114

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Chinese Journal of Contemporary Pediatrics ›› 2022, Vol. 24 ›› Issue (7) : 748-752. DOI: 10.7499/j.issn.1008-8830.2202114

CLINICAL RESEARCH

Effect of sequential sedation and analgesia in preventing delirium and withdrawal symptoms in children after ventilator weaning

YANG Wen-Hai, LAI Zhi-Jun, LI Yan, MA Ke-Ze

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Abstract

Objective To investigate the effect of sequential sedative and analgesic drugs in preventing delirium and withdrawal symptoms in children after ventilator weaning. Methods A retrospective analysis was performed on 61 children who were admitted and received mechanical ventilation support for ≥5 days in the Pediatric Intensive Care Unit of Dongguan Children's Hospital Affiliated to Guangdong Medical University from December 2019 to September 2021. The children were divided into a control group (30 children with no maintenance of analgesic and sedative drugs after ventilator weaning) and an observation group (31 children with sequential sedative and analgesic drugs maintained for 48 hours after ventilator weaning). The two groups were compared in terms of the Sophia Observation Withdrawal Symptoms Scale (SOS) score, the Pediatric Delirium Scale (PD) score, the Richmond Agitation-Sedation Scale (RASS) score, and the incidence rates of delirium or withdrawal symptoms at 24 and 72 hours after ventilator weaning. Results There was no significant difference in the incidence rate of delirium at 24 hours and 72 hours after ventilator weaning between the two groups (P>0.05). Compared with the control group, the observation group had significantly lower incidence rate of withdrawal symptoms and scores of SOS, PD, and RASS scales at 24 hours and 72 hours after ventilator weaning (P<0.01). Conclusions Sequential sedation and analgesia after ventilator weaning can reduce the incidence of withdrawal symptoms within 72 hours after ventilator weaning, but it cannot reduce the incidence rate of delirium.

Key words

Delirium / Withdrawal symptom / Analgesia and sedation / Mechanical ventilation / Child

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YANG Wen-Hai, LAI Zhi-Jun, LI Yan, MA Ke-Ze. Effect of sequential sedation and analgesia in preventing delirium and withdrawal symptoms in children after ventilator weaning[J]. Chinese Journal of Contemporary Pediatrics. 2022, 24(7): 748-752 https://doi.org/10.7499/j.issn.1008-8830.2202114

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