Abstract:
OBJECTIVE:Apply a sedoanalgesic (SA) protocol for invasive procedures (PI) in pediatric patients and evaluate its effectiveness and safety. DESIGN:Prospective observational study. SCOPE:Pediatric Intensive Care Unit (PICU) of third level hospital. PATIENTS:A total of 110 children subjected to invasive procedures under sedoanalgesia with propofol and fentanyl. INTERVENTION:Sedoanalgesic protocol for invasive procedure was applied with: fentanyl (1-2 mcg/kg with maximum dose of 100 mcg for first dose and 50 mcg for the next) and propofol (1-2 mg/kg with maximum of 100 mg for first dose and 50 mg for the next). The objective was to reach III-IV sedoanalgesic grade for modified Ramsay scale and amnesia related to invasive procedure. MAIN ENDPOINTS: a) time to sedoanalgesia and recovery, length for invasive procedure and stay in the Pediatric Intensive Care Unit; b) mean dose of drug; c) sedoanalgesic grade and amnesia related to invasive procedure and d) adverse events. RESULTS:Five hundreds SA were made for 634 IP in 110 children. The most common conditions were oncohematologics (91%), the spinal tap for intrathecal treatment was the most frequent IP (48.5%). Most of the patients (96.8%) did not recall the procedure and an optimum SA was obtained in 93.4%. Patients profoundly sedated presented a significant fall of systolic arterial pressure (88 +/- 19 vs 98 +/- 14 mmHg, p < 0.001) compared to those with minor SA level, as well as heart rate (88 +/- 17 vs 91 +/- 25 bpm, p < 0.05) and respiratory rate (19 +/- 6 vs 23 +/- 11 bpm, p < 0.05). Mean time to reach adequate sedation was 4.62 +/- 3.69 minutes and stay time in PICU 41.8 +/- 19. Complication incidence was 6.6% (apnea, hypotension, bradycardia), these were resolved with manual ventilation and/or volume expansion. CONCLUSIONS:SA protocol reached its goal of: a) effectiveness: SA achieved was optimal, with amnesia of the procedure in almost all patients and b) safety: complications were controlled due to monitorization and stabilization measurements.
journal_name
Med Intensivajournal_title
Medicina intensivaauthors
López JM,Valerón M,Pérez O,Consuegra E,Urquía L,Morón A,González Rdoi
10.1016/s0210-5691(07)74851-9subject
Has Abstractpub_date
2007-11-01 00:00:00pages
417-22issue
8eissn
0210-5691issn
1578-6749pii
13111620journal_volume
31pub_type
杂志文章abstract::Brain death has been recognized by the scientific community as the person's death, and accepted in the legislation of different countries. Brain death is defined as the irreversible ending of the functions of all the intracranial neurological structure in both the brain and brain stem. This clinical situation appears ...
journal_title:Medicina intensiva
pub_type: 杂志文章,评审
doi:10.1016/s0210-5691(09)71215-x
更新日期:2009-05-01 00:00:00
abstract::Patients with cardiac disease can develop two types of malnutrition: cardiac cachexia, which appears in chronic congestive heart failure, and malnutrition due to the complications of cardiac surgery or any other type of surgery in patients with heart disease. Early enteral nutrition should be attempted if the oral rou...
journal_title:Medicina intensiva
pub_type: 共识发展会议,杂志文章,实务指引
doi:10.1016/S0210-5691(11)70017-1
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journal_title:Medicina intensiva
pub_type: 共识发展会议,杂志文章
doi:10.1016/j.medin.2012.08.010
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abstract::Tuberculosis miliar is a very rare complication of bacillus Calmette-Guérin (BCG) immunotherapy that is associated to high mortality. Thus, early diagnosis and treatment is essential. At present, there is a polymerase chain reaction technique (PCR) which is a rapid diagnostic method with elevated sensitivity. Treatmen...
journal_title:Medicina intensiva
pub_type: 杂志文章
doi:10.1016/s0210-5691(06)74485-0
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abstract::The diagnosis of influenza A/H1N1 is mainly clinical, particularly during peak or seasonal flu outbreaks. A diagnostic test should be performed in all patients with fever and flu symptoms that require hospitalization. The respiratory sample (nasal or pharyngeal exudate or deeper sample in intubated patients) should be...
journal_title:Medicina intensiva
pub_type: 杂志文章,实务指引
doi:10.1016/j.medin.2011.11.020
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abstract::Maintaining organ viability from extraction to transplantation is crucial to ensure the function and survival of the graft. In recent years, maintaining organ viability has become more challenging because the shortage of donors has led to broader criteria for donor acceptability and consequently to organs with greater...
journal_title:Medicina intensiva
pub_type: 杂志文章
doi:10.1016/S0210-5691(09)72196-5
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abstract::Both acute myocardial infarction and pulmonary thromboembolism are responsible for a great number of cardiac arrests. Both present high rates of mortality. Thrombolysis has proved to be an effective treatment for acute myocardial infarction and pulmonary thromboembolism with shock. It would be worth considering whethe...
journal_title:Medicina intensiva
pub_type: 杂志文章,评审
doi:10.1016/s0210-5691(06)74470-9
更新日期:2006-03-01 00:00:00
abstract::We maintain a dynamic position on extracorporeal blood purification therapies (EBPT). Continuous therapies are of choice in the hemodynamically unstable patient. We recommend their early introduction in the course of the disease, and starting with a dose of 30-35mL/kg/h. Above all, however, daily re-evaluation is requ...
journal_title:Medicina intensiva
pub_type: 杂志文章
doi:10.1016/j.medin.2016.05.009
更新日期:2016-10-01 00:00:00
abstract:OBJECTIVE:An evaluation is made of the hospital mortality predicting capacity of the main predictive scoring systems. DESIGN:A 2-year retrospective cohort study was carried out. SETTING:A third level ICU with surgical and medical patients. PATIENTS:All patients with multiorgan failure during the first day in the ICU...
journal_title:Medicina intensiva
pub_type: 杂志文章
doi:10.1016/j.medin.2015.03.005
更新日期:2016-04-01 00:00:00
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journal_title:Medicina intensiva
pub_type: 共识发展会议,杂志文章,实务指引
doi:10.1016/j.medin.2020.03.005
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abstract::Departments of Critical Care Medicine are characterized by high medical assistance costs and great complexity. Published recommendations on determining the needs of medical staff in the DCCM are based on low levels of evidence and attribute excessive significance to the structural/welfare approach (physician-to-beds r...
journal_title:Medicina intensiva
pub_type: 杂志文章
doi:10.1016/j.medin.2017.09.013
更新日期:2018-01-01 00:00:00
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journal_title:Medicina intensiva
pub_type: 杂志文章
doi:10.1016/j.medin.2012.04.010
更新日期:2013-01-01 00:00:00
abstract:OBJECTIVE:Assessment of health related quality of life (HRQOL) before and 12 months after discharge from a mixed intensive care unit (ICU) according to diagnostic category and the relationship between both instruments. DESIGN:Prospective observational study. SETTING:The combined medical/surgical ICU in a secondary un...
journal_title:Medicina intensiva
pub_type: 杂志文章
doi:10.1016/s0210-5691(08)70942-2
更新日期:2008-06-01 00:00:00
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journal_title:Medicina intensiva
pub_type: 杂志文章,评审
doi:10.1016/j.medin.2011.11.010
更新日期:2012-10-01 00:00:00
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journal_title:Medicina intensiva
pub_type: 杂志文章
doi:10.1016/j.medin.2010.04.003
更新日期:2010-11-01 00:00:00
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journal_title:Medicina intensiva
pub_type:
doi:10.1016/j.medin.2014.04.012
更新日期:2014-11-01 00:00:00
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journal_title:Medicina intensiva
pub_type: 杂志文章,评审
doi:10.1016/j.medin.2011.05.005
更新日期:2011-11-01 00:00:00
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journal_title:Medicina intensiva
pub_type: 杂志文章
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更新日期:2007-01-01 00:00:00
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journal_title:Medicina intensiva
pub_type: 杂志文章
doi:10.1016/j.medin.2011.10.006
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journal_title:Medicina intensiva
pub_type: 杂志文章
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更新日期:2012-11-01 00:00:00
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journal_title:Medicina intensiva
pub_type: 杂志文章,多中心研究
doi:10.1016/j.medin.2017.09.007
更新日期:2018-01-01 00:00:00
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journal_title:Medicina intensiva
pub_type: 杂志文章
doi:10.1016/j.medin.2013.08.006
更新日期:2014-08-01 00:00:00
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journal_title:Medicina intensiva
pub_type: 杂志文章,评审
doi:10.1016/j.medin.2020.04.003
更新日期:2020-05-29 00:00:00
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journal_title:Medicina intensiva
pub_type: 共识发展会议,杂志文章,实务指引
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更新日期:2011-11-01 00:00:00
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journal_title:Medicina intensiva
pub_type: 杂志文章
doi:10.1016/s0210-5691(07)74833-7
更新日期:2007-08-01 00:00:00
abstract:OBJECTIVE:To assess the impact of gender upon the prognosis and medical care in a regional acute ST-elevation myocardial infarction management network. DESIGN:An observational study was made of consecutive patients entered in a prospective database. SCOPE:The Catalan acute ST-elevation myocardial infarction managemen...
journal_title:Medicina intensiva
pub_type: 杂志文章,多中心研究
doi:10.1016/j.medin.2016.06.008
更新日期:2017-03-01 00:00:00
abstract::Transient apical dysfunction syndrome, ballooning or Takotsubo cardiomyopathy is a recently described syndrome. It is a disease with a partially known mechanism, characterized by the morphology adopted by the left ventricle secondary to hypokinesis and dyskinesis of the apical segments and hypercontractibility of the ...
journal_title:Medicina intensiva
pub_type: 杂志文章,评审
doi:10.1016/s0210-5691(07)74793-9
更新日期:2007-04-01 00:00:00
abstract::Thoracic surgery has undergone significant advances in recent years related to anesthetic and surgical techniques and the prevention and management of complications related to the procedure. This has allowed improvements in patient clinical outcomes in surgeries of this kind. Despite the above, thoracic surgery, espec...
journal_title:Medicina intensiva
pub_type: 杂志文章
doi:10.1016/j.medin.2019.10.012
更新日期:2020-04-01 00:00:00
abstract::Cerebrovascular accident in young adults is not rare and the most common causes are: cardiac embolism, arterial dissection and migraine. The unknown etiology, in spite of extensive studies, is described in the literature in about one third of patients under 45 years of age. The mitochondrial encephalomyopathy, lactic ...
journal_title:Medicina intensiva
pub_type: 杂志文章
doi:10.1016/s0210-5691(08)70925-2
更新日期:2008-04-01 00:00:00
abstract:OBJECTIVE:To determine the clinical characteristics and prognostic factors of patients with severe sepsis/septic shock admitted to the Intensive Care Unit of Donostia University Hospital (Guipuzcoa, Spain). DESIGN:A prospective, observational study was carried out during a consecutive 6-year period (1st February 2008-...
journal_title:Medicina intensiva
pub_type: 杂志文章
doi:10.1016/j.medin.2015.01.006
更新日期:2016-01-01 00:00:00