土耳其儿科重症监护室的镇静、镇痛、肌肉松弛剂、戒断和谵妄做法。

Esra Koçkuzu, Ali Korulmaz, Ümit Altuğ, Gürkan Bozan, Dinçer Yıldızdaş
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引用次数: 0

摘要

背景:疼痛和镇静管理是儿科重症监护实践中不可或缺的一部分。镇静镇痛管理必须保持平衡,以优化舒适度并避免并发症。为了实现这一平衡,需要明确儿科重症监护病房(PICU)的镇静镇痛管理。通过这项研究,我们旨在调查土耳其儿科重症监护病房的镇静、镇痛、戒断和谵妄做法、药剂偏好以及目前在评分系统方面的经验和做法:通过电子邮件向 "儿科重症监护和急诊 "小组发送了一份包含 57 个问题的调查问卷,该小组成员包括土耳其的所有重症监护专家、亚专业学生和讲师:我们的研究涉及 36 名在土耳其儿科重症监护病房工作的儿科重症监护医生。在参与研究的 PICU 专家中,83.3% 表示他们对镇静效果进行过常规评估。右美托咪定是接受无创机械通气患者最常用的镇静剂,而苯二氮卓类药物则是机械通气过程中最常用的镇静剂。在参与研究的儿科重症监护医生中,94.4% 的人表示他们在自己的病房中进行过常规疼痛评估。在参与研究的儿童重症监护病房专家中,69.4% 的专家表示肌肉松弛剂最常用于预防机械通气期间患者与呼吸机的不协调。88.8%的参与者在停用镇静镇痛药时进行了停药评估。58.3%的参与者常规进行谵妄评估:这项研究表明,土耳其 PICU 在镇静镇痛管理方面的做法与镇静指南的建议一致。尽管镇静镇痛管理的敏感性有所提高,但对谵妄和戒断综合征管理的认识却未达到预期水平。因此,有必要在土耳其就这些问题制定指南、提高认识并加强培训。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Sedation - analgesia - muscle relaxant - withdrawal and delirium practices in pediatric intensive care units in Türkiye.

Background: Pain and sedation management is an integral part of pediatric intensive care practice. Sedoanalgesia management must be balanced in order to optimize comfort and avoid complications. In order to achieve this balance, sedoanalgesia management needs to be clarified in pediatric intensive care units (PICU). With this study, we aimed to investigate sedation, analgesia, withdrawal and delirium practices, pharmacologic agent preferences, and current experiences and practices in scoring systems in PICUs in Türkiye.

Method: A questionnaire consisting of 57 questions was sent via e-mail to the 'Pediatric Intensive Care and Emergency' group, which includes all intensive care specialists, subspecialty students and lecturers in Türkiye.

Results: Our study involved 36 pediatric intensive care physicians working in PICUs in Türkiye. Among the PICU specialists who participated in the study, 83.3% stated that they performed routine assessments of sedation efficacy. While dexmedetomidine was the most commonly used sedative agent in patients undergoing noninvasive mechanical ventilation, benzodiazepines were the most preferred pharmacologic agent for sedation during mechanical ventilation. Of the pediatric intensivists who participated in the study, 94.4% stated that they performed routine pain assessments in their units. Of the PICU specialists who participated in the study, 69.4% stated that muscle relaxants were most commonly used to prevent patient-ventilator incompatibility during mechanical ventilation. Of the participants, 88.8% made withdrawal assessments when discontinuing sedo-analgesic agents. Delirium assessment was routinely performed by 58.3% of the participants.

Conclusions: This study showed that the practices in sedoanalgesia management in PICUs in Türkiye are in parallel with recommendations of the sedation guideline. Despite the increased sensitivity in sedoanalgesia management, awareness in the management of delirium and withdrawal syndrome is not at the desired level. Therefore, there is a need to develop guidelines, raise awareness and increase training on these issues in our Türkiye.

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