A multicenter survey on the situation and characteristics of severe cardiac analgesia, sedation and delirium in children
10.3760/cma.j.cn115682-20220129-00503
- VernacularTitle:儿童心脏重症镇痛、镇静及谵妄实践现状及特点的多中心调查
- Author:
Yemin GONG
1
;
Ping NI
;
Wenyi LUO
;
Yongmei GUAN
;
Yibei WU
Author Information
1. 上海交通大学医学院附属上海儿童医学中心心胸外科，上海 200127
- Keywords:
Child;
Severe heart disease;
Congenital heart disease;
Analgesia;
Sedation;
Delirium
- From:
Chinese Journal of Modern Nursing
2022;28(35):4863-4869
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the situation and characteristics of the practice of severe cardiac analgesia, sedation and delirium in children in China, so as to lay a research foundation for standardizing the prevention process of severe cardiac analgesia, sedation and delirium in children.Methods:This study was a cross-sectional study, using questionnaire survey. The Analgesia, Sedation and Delirium Practice Questionnairewas designed according to consensus, clinical suggestions and clinical practice. In August 2021, the electronic questionnaire was issued to the Children's Cardiac Intensive Care Unit (ICU) in children's hospitals through the Pediatric Nursing Alliance Pediatric Congenital Nursing Group of the National Children's Medical Center. A total of 15 ICUs were included, all of which completed the survey, and the effective recovery rate of the questionnaire was 100%.Results:The 15 ICUs all had pain assessment system, including 11 with pain assessment standard operating procedures, 8 with sedation assessment standard operating procedures, and 4 with delirium assessment. However, there was no specific process or system for delirium assessment in ICU. All 15 ICUs used analgesics, 8 of them used opioids for analgesia immediately after cardiac surgery, 5 of them used analgesics according to the patient's condition, 2 of them used analgesics according to the pain score. Non-steroidal paracetamol was the first choice for non-postoperative children, and 6 of 15 ICUs used analgesics according to the pain score. All 15 ICUs used sedative drugs, 6 of which used sedative drugs within 1 hour after admission, 6 of which were decided by the doctor according to the situation of the child, 3 of which used sedative drugs according to the sedation score, and 7 of which used midazolam as the first choice. A total of 6 the 15 ICUs carried out some projects in the "ABCDEF" delirium prevention program.Conclusions:In this investigation, the use of analgesic and sedative drugs in ICU is heterogeneous, the evaluation process of analgesia and sedation has not been established, and delirium has not attracted enough attention. Rational sedation and analgesia need to develop standardized sedation and analgesia evaluation procedures. At present, high-quality clinical studies are still needed to provide data support for the construction of standardized processes.
