Abstract P-487: MONITORING AND MANAGEMENT OF SEDOANALGESIA IN SPANISH PEDIATRIC INTENSIVE CARE UNITS. MONISEDA PROJECT

Abstract

Aims & Objectives: To review the monitoring of sedoanalgesia and the use of sedative, analgesic and muscle relaxant drugs in spanish pediatric intensive care units (PICU). Methods A prospective multicentre observational study was performed in 15 PICUs for 2 months. Level of sedation, analgesia and withdrawal syndrome was monitored by pain scales, COMFORT scale and Sophia Observation withdrawal Symptoms scale (SOS) once per shift. Results 489 children (55% male) were studied. The mean age was 4.2 ± 4.7 years and mean weight was 21 ± 18 Kg. 53% were non-surgical patients. Median length of stay was 3 days (IQR: 2–5). 30% of patients had mechanical ventilation (MV) and 1.8% died. Analgesia scale was performed in 97% of patients; the mean score was 1.5 ± 1.4, with a mean maximum score of 3.1 ± 2.4, during 4.6 ± 6.6 days. Sedation assessment was performed in 37% of patients with the COMFORT scale, the mean score was 18.3 ± 5.9 during 4.6 ± 6.9 days. Most commonly used intravenous analgesic drug was metamizole (38%), followed by fentanyl (23%) and morphine (6%). Midazolam (20%) was the most commonly used drug for sedation, followed by propofol (6%) and dexmedetomidine (1.5%). Neuromuscular blockers were used in 4.3% of children (18% of patients undergoing MV). Enteral sedoanalgesia was used in 16% of patients. Conclusions The most frequently used drugs in the spanish PICUs are metamizole as an analgesic and midazolam as a sedative. The use of scales could improve the quality of sedation and analgesia.