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 correlati...

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Detalles Bibliográficos
Autores: Bosch-Alcaraz, Alejandro, Luna Castaño, Patricia, Garcia-Soler, Patricia, Tamame-San Antonio, Marta, Falcó-Pegueroles, Anna, Alcolea-Monge, Sandra, Fernández Lorenzo, Rocío, Piqueras-Rodríguez, Pedro, Molina-Gallego, Irene, Potes-Rojas, Cristina, Gesti-Senar, Silvia, Orozco-Gamez, Rocío, Tercero-Cano, María Carmen, Saz-Roy, M. Ángeles, Jordan, Iolanda, Belda-Hofheinz, Sylvia
Tipo de recurso: artículo
Fecha de publicación:2020
País:España
Institución:Universidad Autónoma de Madrid
Repositorio:Biblos-e Archivo. Repositorio Institucional de la UAM
Idioma:español
OAI Identifier:oai:repositorio.uam.es:10486/704873
Acceso en línea:http://hdl.handle.net/10486/704873
https://dx.doi.org/10.1016/j.anpedi.2020.10.016
Access Level:acceso abierto
Palabra clave:COMFORT
Infant welfare
Paediatric Intensive Care Unit
Sedation
Withdrawal syndrome
Unidad de Cuidados Intensivos Pediátricos
Bienestar infantil
Sedación
Síndrome de abstinencia
Medicina
Descripción
Sumario: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 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.