Guía clínica multidisciplinaria para el uso de analgesia y sedación; prevención de delirium y abstinencia

Autores/as

DOI:

https://doi.org/10.47464/MetroCiencia/vol29/1/2021/7-15

Palabras clave:

Analgesia, sedación, delirium, abstinencia, equipo multidisciplinario

Resumen

El ingreso a la UCIP somete al niño a una serie de estímulos y procedimientos estresantes y dolorosos. El uso de analgesia y sedación es un componente central en los cuidados del niño críticamente enfermo para asegurar su confort y seguridad. Es importante durante la prescripción de analgosedación la monitorización continua de sus efectos. Este proceso debe ser vigilado por todos los integrantes del equipo de salud y su familia. Esta guía se basa en los principios propuestos por la iniciativa “Libérame de la UCI”, que consisten en un paquete (bundle) de medidas (ABCDEF) para optimizar la recuperación de los pacientes y sus desenlaces. Contiene tablas con la farmacología de los analgésicos y sedantes, con estrategias generales para el manejo de analgosedación y prevención del síndrome de abstinencia y delirium. Guía realizada por el equipo multidisciplinario para lograr una adherencia más completa.

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Biografía del autor/a

Rocío Yerovi, Hospital Metropolitano

UCI Pediátrica, Jefa de la UCIP; Hospital Metropolitano; Quito, Ecuador

Paola Pico Aguilar, Hospital Metropolitano

Pediatra Neonatóloga; Hospital Metropolitano; Quito, Ecuador

Susana Espinoza, Hospital Metropolitano

Enfermera/o, Jefa de Enfermería de la UCIP, Hospital Metropolitano; Quito, Ecuador

Martha Cuñas, Hospital Metropolitano

Enfermera/o; Hospital Metropolitano; Quito, Ecuador

Santiago Espinosa, Hospital Metropolitano

Enfermera/o; Hospital Metropolitano; Quito, Ecuador

Gabriela Arévalo, Hospital Metropolitano

Servicio de Rehabilitación; Hospital Metropolitano; Quito, Ecuador

Francisco Espinel, Hospital Metropolitano

Servicio de Neurología Pediátrica; Hospital Metropolitano; Quito, Ecuador

Santiago Campos-Miño, Hospital Metropolitano

UCI Pediátrica; Hospital Metropolitano; Quito, Ecuador

Citas

Marra A, Ely EW, Pandharipande PP, et al. The ABCDEF bundle in critical care. Crit Care Clin 2017; 33:225–243.

Harris J, Ramelet AS, van Dijk M, et al. Clinical recommendations for pain, sedation, withdrawal and delirium assessment in critically ill infants and children: An ESPNIC position statement for healthcare professionals. Intensive Care Med 2016; 42:972–986.

Van Dijk M, de Boer JB, Koot HM, et al. The reliability and validity of the COMFORT scale as a postoperative pain instrument in 0 to 3-year-old infants. Pain 2000; 84: 367–377.

Bai J, Hsu L, Tang Y, van Dijk M. Validation of the COMFORT behavior scale and the FLACC scale for pain assessment in Chinese children after cardiac surgery. Pain Manag Nurs 2012; 13: 18–26.

Boerlage AA, Ista E, Duivenvoorden HJ, et al. The COMFORT behaviour scale detects clinically meaningful effects of analgesic and sedative treatment. Eur J Pain 2015; 19: 473–479.

Johansson M, Kokinsky E. The COMFORT behavioural scale and the modified FLACC scale in paediatric intensive care. Nurs Crit Care 2009; 14: 122–130.

Ramelet AS, Rees N, McDonald S, et al. Development and preliminary psychometric testing of the multidimensional assessment of pain scale: MAPS. Paediatr Anaesth 2007; 17: 333–340.

Keogh SJ, Long DA, Horn DV. Practice guidelines for sedation and analgesia management of critically ill children: A pilot study evaluating guideline impact and feasibility in the PICU. BMJ Open 2015; 5: e006428.

Kerson AG, DeMaria R, Mauer E, et al. Validity of the Richmond Agitation-Sedation Scale (RASS) in critically ill children. J Intensive Care 2016; 4: 65.

Cravero JP, Askins N, Sriswasdi P, et al. Validation of the Pediatric Sedation State Scale. Pediatrics 2017; 139: e20162897.

Walker T, Kudchadkar SR. Pain and Sedation Management: 2018 Update for the Rogers’ Textbook of Pediatric Intensive Care. Pediatr Crit Care Med 2019; 20: 54-61.

Kamat PP, Kudchadkar SR. IV Clonidine in the PICU: Time for Dexmedetomidine to share the limelight? Pediatr Crit Care Med 2018; 19: 792–794.

Grant MJ, Schneider JB, Asaro LA, et al. Randomized Evaluation of Sedation Titration for Respiratory Failure Study Investigators: Dexmedetomidine use in critically ill children with acute respiratory failure. Pediatr Crit Care Med 2016; 17: 1131–1141.

Venkatraman R, Hungerford JL, Hall MW, et al. Dexmedetomidine for sedation during noninvasive ventilation in pediatric patients. Pediatr Crit Care Med 2017; 18: 831–837.

Shutes BL, Gee SW, Sargel CL, et al. Dexmedetomidine as single continuous sedative during noninvasive ventilation: Typical usage, hemodynamic effects, and withdrawal. Pediatr Crit Care Med 2018; 19: 287–297.

Jenkins IA, Playfor SD, Bevan C, et al. Current United Kingdom sedation practice in pediatric intensive care. Paediatr Anaesth 2007; 17: 675–683.

Sfoggia A, Fontela PS, Moraes A, et al. Sedation and analgesia in children submitted to mechanical ventilation could be overestimated? J Pediatr (Rio J) 2003; 79: 343–348.

Fonsmark L, Rasmussen YH, Carl P. Occurrence of withdrawal in critically ill sedated children. Crit Care Med 1999; 27: 196–199.

Katz R, Kelly HW, Hsi A. Prospective study on the occurrence of withdrawal in critically ill children who receive fentanyl by continuous infusion. Crit Care Med 1994; 22: 763–767.

Sanchez-Pinto LN, Nelson LP, Lieu P, et al. Implementation of a risk stratified opioid weaning protocol in a pediatric intensive care unit. J Crit Care 2018; 43:214–219.

Robertson RC, Darsey E, Fortenberry JD, et al. Evaluation of an opiate-weaning protocol using methadone in pediatric intensive care unit patients. Pediatr Crit Care Med 2000; 1:119–123.

Franck LS, Harris SK, Soetenga DJ, et al. The withdrawal assessment tool-1 (WAT-1): an assessment instrument for monitoring opioid and benzodiazepine withdrawal symptoms in pediatric patients. Pediatr Crit Care Med 2008; 9: 573–580.

Franck LS, Scoppettuolo LA, Wypij D, et al. Validity and generalizability of the withdrawal assessment tool-1 (WAT-1) for monitoring iatrogenic withdrawal syndrome in pediatric patients. Pain 2012; 153: 142–148.

Ista E, van Dijk M, de Hoog M, et al. Construction of the Sophia observation withdrawal symptoms-scale (SOS) for critically ill children. Intensive Care Med 2009; 35: 1075–1081.

Ista E, de Hoog M, Tibboel D, et al. Psychometric evaluation of the Sophia observation withdrawal symptoms scale in critically Ill children. Pediatr Crit Care Med 2013; 14: 761–769.

Devlin JW, Skrobik Y, Gélinas C, et al. Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU. Crit Care Med 2018; 46: e825-e840.

Publicado

2021-01-29

Cómo citar

Yerovi, R., Pico Aguilar, P., Espinoza, S., Cuñas, M., Espinosa, S., Arévalo, G., Espinel, F., & Campos-Miño, S. (2021). Guía clínica multidisciplinaria para el uso de analgesia y sedación; prevención de delirium y abstinencia. Metro Ciencia, 29(1), 7–15. https://doi.org/10.47464/MetroCiencia/vol29/1/2021/7-15

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Guías Clínicas

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