Use of sedatives and analgesics and hospital outcomes in pediatric intensive care: a cohort study

ABSTRACT BACKGROUND AND OBJECTIVES Continuous infusion sedoanalgesia may favor negative hospital outcomes, thus, the objective was to analyze the relationship between continuous infusion sedoanalgesia and factors such as duration of mechanical pulmonary ventilation (MPV), extubation failure, hospita...

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Veröffentlicht in:BrJP 2022-06, Vol.5 (2), p.105-111
Hauptverfasser: Vieira, Tayná, Linck-Júnior, Arnildo, Teresa Grubisich Mendes Tacla, Mauren, Aparecida Pimenta Ferrari, Rosângela, Lopes Gabani, Flávia
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Sprache:eng ; por
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Zusammenfassung:ABSTRACT BACKGROUND AND OBJECTIVES Continuous infusion sedoanalgesia may favor negative hospital outcomes, thus, the objective was to analyze the relationship between continuous infusion sedoanalgesia and factors such as duration of mechanical pulmonary ventilation (MPV), extubation failure, hospital infections, length of hospitalization, and death in a mixed pediatric intensive care unit (PICU). The aim of this study was to identify the association of the use of sedatives and analgesics in continuous infusion with hospital outcomes through the control of confounding variables. METHODS Retrospective cohort with hospitalizations of children aged zero to 14 years, from 2012 to 2017. Use of continuous sedoanalgesia was considered a factor for the outcomes: duration of MPV, extubation failure, hospital infections (healthcare-associated infections - HCAI, fungal infection and catheter-related bloodstream infection), length of stay in the PICU and hospital, and death. Poisson regression was performed with adjustment by progressive models, with a significance level of 5%, calculation of relative risk (RR) and confidence interval (95% CI). RESULTS A total of 894 hospitalizations were analyzed, with a predominance of males (54.3%), non-malnourished children (70.7%) and without a diagnosis of chronic disease (55.1%). Infants accounted for half of the population. The outcomes that were associated with continuous sedoanalgesia in the final model were: MPV time > 4 days (RR=2.74; 95%CI=1.90-3.93), HCAI (RR=1.91; 95%CI=.32-2.80), fungal infection (RR=2.00; 95%CI=1.12-3.58), length of stay in the PICU > 3 days (RR=1.81; 95%CI=1.51-2.17) and hospital stay > 10 days (RR=1.52; 95%CI=1.27-1.84), and death (RR=0.64; 95%CI=0.43-0.95). CONCLUSION MPV time longer than four days, diagnosis of HCAI, diagnosis of fungal infection, length of stay in the PICU longer than three days, and hospitalization time longer than 10 days were factors more present in children who received continuous infusion of sedoanalgesia. Death, on the other hand, was more related to severity variables than to the use of psychoactive drugs.
ISSN:2595-0118
2595-3192
DOI:10.5935/2595-0118.20220030-en