Importance of the use of protocols for the management of analgesia and sedation in pediatric intensive care unit. Motta, E., Luglio, M., Delgado, A. F., & Carvalho, W. B. d. Revista da Associacao Medica Brasileira (1992), 62(6):602--609, 2016. Motta, Emiliana. Assistant Physician at the Pediatric Intensive Care Unit (PICU), Instituto da Crianca, Hospital das Clinicas, Faculdade de Medicina, Universidade de Sao Paulo (HC-FMUSP), Sao Paulo, SP, Brazil. Luglio, Michele. Clinical Preceptor at the PICU, Instituto da Crianca, HC-FMUSP, Sao Paulo, SP, Brazil. Delgado, Artur Figueiredo. Professor, Habilitation (BR: Livre-docencia), Department of Pediatrics, FMUSP. Coordinator of the PICU, Instituto da Crianca, HC-FMUSP, Sao Paulo, SP, Brazil. Carvalho, Werther Brunow de. Full Professor of Intensive Care/Neonatology, Department of Pediatrics, FMUSP, Sao Paulo, SP, Brazil.
abstract   bibtex   
Introduction:: Analgesia and sedation are essential elements in patient care in the intensive care unit (ICU), in order to promote the control of pain, anxiety and agitation, prevent the loss of devices, accidental extubation, and improve the synchrony of the patient with mechanical ventilation. However, excess of these medications leads to rise in morbidity and mortality. The ideal management will depend on the adoption of clinical and pharmacological measures, guided by scales and protocols., Objective:: Literature review on the main aspects of analgesia and sedation, abstinence syndrome, and delirium in the pediatric intensive care unit, in order to show the importance of the use of protocols on the management of critically ill patients., Method:: Articles published in the past 16 years on PubMed, Lilacs, and the Cochrane Library, with the terms analgesia, sedation, abstinence syndrome, mild sedation, daily interruption, and intensive care unit., Results:: Seventy-six articles considered relevant were selected to describe the importance of using a protocol of sedation and analgesia. They recommended mild sedation and the use of assessment scales, daily interruptions, and spontaneous breathing test. These measures shorten the time of mechanical ventilation, as well as length of hospital stay, and help to control abstinence and delirium, without increasing the risk of morbidity and morbidity., Conclusion:: Despite the lack of controlled and randomized clinical trials in the pediatric setting, the use of protocols, optimizing mild sedation, leads to decreased morbidity.
@article{motta_importance_2016-1,
	title = {Importance of the use of protocols for the management of analgesia and sedation in pediatric intensive care unit.},
	volume = {62},
	issn = {1806-9282},
	abstract = {Introduction:: Analgesia and sedation are essential elements in patient care in the intensive care unit (ICU), in order to promote the control of pain, anxiety and agitation, prevent the loss of devices, accidental extubation, and improve the synchrony of the patient with mechanical ventilation. However, excess of these medications leads to rise in morbidity and mortality. The ideal management will depend on the adoption of clinical and pharmacological measures, guided by scales and protocols., Objective:: Literature review on the main aspects of analgesia and sedation, abstinence syndrome, and delirium in the pediatric intensive care unit, in order to show the importance of the use of protocols on the management of critically ill patients., Method:: Articles published in the past 16 years on PubMed, Lilacs, and the Cochrane Library, with the terms analgesia, sedation, abstinence syndrome, mild sedation, daily interruption, and intensive care unit., Results:: Seventy-six articles considered relevant were selected to describe the importance of using a protocol of sedation and analgesia. They recommended mild sedation and the use of assessment scales, daily interruptions, and spontaneous breathing test. These measures shorten the time of mechanical ventilation, as well as length of hospital stay, and help to control abstinence and delirium, without increasing the risk of morbidity and morbidity., Conclusion:: Despite the lack of controlled and randomized clinical trials in the pediatric setting, the use of protocols, optimizing mild sedation, leads to decreased morbidity.},
	number = {6},
	journal = {Revista da Associacao Medica Brasileira (1992)},
	author = {Motta, Emiliana and Luglio, Michele and Delgado, Artur Figueiredo and Carvalho, Werther Brunow de},
	year = {2016},
	note = {Motta, Emiliana. Assistant Physician at the Pediatric Intensive Care Unit (PICU), Instituto da Crianca, Hospital das Clinicas, Faculdade de Medicina, Universidade de Sao Paulo (HC-FMUSP), Sao Paulo, SP, Brazil.
Luglio, Michele. Clinical Preceptor at the PICU, Instituto da Crianca, HC-FMUSP, Sao Paulo, SP, Brazil.
Delgado, Artur Figueiredo. Professor, Habilitation (BR: Livre-docencia), Department of Pediatrics, FMUSP. Coordinator of the PICU, Instituto da Crianca, HC-FMUSP, Sao Paulo, SP, Brazil.
Carvalho, Werther Brunow de. Full Professor of Intensive Care/Neonatology, Department of Pediatrics, FMUSP, Sao Paulo, SP, Brazil.},
	keywords = {*Analgesia/mt [Methods], *Clinical Protocols/st [Standards], *Delirium/pc [Prevention \& Control], *Intensive Care Units, Pediatric, *Substance Withdrawal Syndrome/pc [Prevention \& Control], Analgesics/ad [Administration \& Dosage], Child, Humans, Hypnotics and Sedatives/ad [Administration \& Dosage], critical illness, male},
	pages = {602--609}
}

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