Sedation and neurodevelopmental outcomes in PICU: identification of study groups

Abstract

Background/Aims

As little as 30 minutes of exposure to anesthetic and sedative agents may adversely affect the developing brain. Safe, humane management of critically ill infants requires the use of sedative agents, often for prolonged periods. We sought to identify two comparable groups of critical care patients who did or did not receive sedatives, with the aim of designing a long‐term neuro‐development follow‐up study. This feasibility study aimed to determine if two comparable groups could be found.

Methods

Infants with respiratory diagnoses having non‐invasive ventilation without sedation (Group C) or intubation and ventilation with sedation (Group S) were identified by chart review. Charts of patients fulfilling the above inclusion criteria were searched for exclusion criteria including neurological disease, extreme prematurity, congenital cardiac disease, genetic anomalies. Data was extracted to score pediatric severity of illness scores (PRISM and PELOD) for each patient. These scores were then compared using the absolute scores and by risk strata.

Results

Group S included 33 patients and Group C had 39. The absolute PRISM and PELOD scores were different between groups, Comparing the groups in 3 risk strata (PRISM greater or less than 5 or 10) there were no significant differences between groups

Conclusions

It is not possible to randomise infants to sedation or no sedation to investigate neurodevelopmental outcomes. This phase of the project aimed to determine the comparability of 2 groups of PICU patients.

These findings indicate that these groups could be enrolled as exposed and control subjects in an outcomes study.

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