Grado de disconfort del paciente crítico pediátrico y correlación con variables sociodemográficas y clínicas, analgosedación y síndrome de abstinencia. Estudio multicéntrico COSAIP (Fase 2)
- Alejandro Bosch-Alcaraz
- Patricia Luna-Castano
- Patricia Garcia-Soler
- Marta Tamame-San Antonio
- Anna Falcó-Pegueroles
- Sandra Alcolea-Mongea
- Rocío Fernández Lorenzo
- Pedro Piqueras-Rodríguez
- Irene Molina-Gallego
- Cristina Potes-Rojas
- Silvia Gesti-Senar
- Rocío Orozco-Gamez
- María Carmen Tercero-Cano
- M. Ángeles Saz-Roy
- Iolanda Jordana
- Sylvia Belda-Hofheinz
ISSN: 1695-4033, 1696-4608
Ano de publicación: 2021
Volume: 95
Número: 6
Páxinas: 397-405
Tipo: Artigo
Outras publicacións en: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría ( AEP )
Resumo
Introduction There are clinical and sociodemographic factors that have an impact on the comfort of the critically ill paediatric patient. The main aim of this study was to determine the level of discomfort of paediatric patients admitted to different national hospitals, and to analyse its correlation with sociodemographic and clinical variables, analgosedation, and withdrawal syndrome. Methods An observational, analytical, cross-sectional, and multicentre study was conducted in five Spanish hospitals. The level of analgosedation was assessed once per shift over a 24 h period, using a BIS sensor, and pain with scales adapted to paediatric age population. The intensity of withdrawal syndrome was determined using the Withdrawal Assessment Tool (WAT-1) scale once per shift for 3 days. Discomfort level was simultaneous assessed using COMFORT Behaviour Scale-Spanish version (CBS-S). Results A total of 261 critically ill paediatric patients with median age of 1.61 years (IQR = 0.35-6.55) were included. An overall discomfort score of 10.79 ± 3.7 was observed during morning compared to 10.31 ± 3.3 observed during the night. When comparing analgosedation and non-analgosedation groups, statistically differences were found in both shifts (χ2: 45.48; P = .001). At the same time, an association was observed (P < .001) between low discomfort scores and development of withdrawal syndrome development assessed with WAT-1. Conclusions As there is a percentage of the studied population with discomfort, specific protocols need to be developed, guided by valuated and clinically tested tools, like the COMFORT Behaviour Scale-Spanish version.