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Curley MA, et al. "Protocolized sedation vs usual care in pediatric patients mechanically ventilated for acute respiratory failure: a randomized clinical trial". JAMA. 2015. 313(4):379-389.
PubMed

Clinical Question

In pediatric ICU patients aged 2 weeks to 17 years, does a nurse-implemented, goal directed sedation protocol reduce mechanical ventilation days?

Bottom Line

The use of a sedation protocol compared with usual care in critically ill pediatric patients does not reduce the duration of mechanical ventilation.

Major Points

Guidelines

Design

  • Multicenter (31 pediatric ICUs in the US), cluster randomized trial
  • N= 2449 pediatric patients
    • Intervention (17 PICUs): 1225 pediatric patients using protocol with targeted sedation
    • Control (14 PICUs): 1224 pediatric patients managed sedation per usual care
  • Setting: 17 pediatric ICUs in the US
  • Enrollment: 2009-2013
  • Follow-up: 72 hrs after opioids were discontinued, 28 days or hospital discharge

Population

Inclusion Criteria

Exclusion Criteria

Baseline Characteristics

Interventions

Outcomes

Primary Outcomes

Secondary Outcomes

Subgroup Analysis

Adverse Events

Criticisms

Funding

Further Reading