Long-Term Outcomes after Protocolized Sedation versus Usual Care in Ventilated Pediatric Patients

Whether a nurse-implemented goal-directed sedation protocol resulting in more awake yet calm intubated children affects postdischarge functional status, health-related quality of life, or risk for post-traumatic stress disorder is unknown. To compare postdischarge outcomes in children with acute res...

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Bibliographic Details
Published in:American journal of respiratory and critical care medicine 2018-06, Vol.197 (11), p.1457-1467
Main Authors: Watson, R Scott, Asaro, Lisa A, Hertzog, James H, Sorce, Lauren R, Kachmar, Alicia G, Dervan, Leslie A, Angus, Derek C, Wypij, David, Curley, Martha A Q
Format: Article
Language:English
Subjects:
Adolescent
Age
Anesthesia
Asthma
Cancer
Child
Child, Preschool
Children & youth
Clinical trials
Conscious Sedation - methods
Consent
Critical Care - methods
Families & family life
Female
Follow-Up Studies
Guardians
Humans
Hypnotics and Sedatives - therapeutic use
Infant
Infant, Newborn
Intensive care
Male
Original
Parents & parenting
Patients
Pediatrics
Post traumatic stress disorder
Quality of life
Respiration, Artificial - methods
Respiratory Insufficiency - drug therapy
Treatment Outcome
Validity
Ventilators
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Summary:Whether a nurse-implemented goal-directed sedation protocol resulting in more awake yet calm intubated children affects postdischarge functional status, health-related quality of life, or risk for post-traumatic stress disorder is unknown. To compare postdischarge outcomes in children with acute respiratory failure cluster-randomized to a sedation protocol or usual care. A stratified random sample of 1,360 patients from 31 centers in the RESTORE (Randomized Evaluation of Sedation Titration for Respiratory Failure) trial was assessed by mail, electronically, and/or telephone 6 months after ICU discharge. In treatment group comparisons, we controlled for age, baseline functional status, and severity of illness. We used the Pediatric Overall Performance Category and the Pediatric Cerebral Performance Category to characterize functional status, the Infant and Toddler Quality of Life Questionnaire (97-item full-length version) (
ISSN:1073-449X
1535-4970
DOI:10.1164/rccm.201708-1768OC