Assessment of level of sedation and associated factors among Intubated critically ill children in pediatric intensive care unit of Jimma university medical center: a five months prospective Observation study, 2022

Abstract

Background: Sedation can be provided to facilitate a procedure or to stabilize patients admitted in PICU. Sedation is often necessary to maintain optimal care for critically ill children requiring mechanical ventilation. However, if sedation is too deep or too light it has its own adverse effects, and hence it is important to monitor level of sedation and maintain an optimal level. Objectives: assess level of sedation and associated factors among intubated critically ill children admitted to PICU of JUMC, Jimma. Methods: Prospective observation study which was conducted in PICU of JUMC from August, 2021 to December, 2021. Data was collected by residents and nurses working in PICU, after they were given training. Data entry was done using Epi data manager (version 4.6.0.2). Statistical analysis and the creation of charts was performed using SPSS version 26. Data was presented as mean, percentage and standard deviation. To see if level of sedation has any change on patient outcomes was examined using repeated measure ANOVA test. To understand the associated factors of level of sedation chi square test was used. A probability of p<0.05 was defined as statistically significant. Results: Of a total of 49 patients admitted to PICU, level of sedation was assessed for 28 critically ill intubated children. Of a total of 84 sedation scores observed, 45.2% was optimal and 54.8% was suboptimal. The mean age of children was 37.7 months. Patients were taking morphine as a sedative in 78.6% of the cases. There was a change on mortality rate based on the level of sedation, wilk’s Lambda value of 0.725, p-value of 0.018. There was an association between comorbidity and level of sedation, Pearson chi square 0.68, p-value of 0.0132. Conclusion: this small preliminary study showed a high proportion of suboptimal level of sedation in PICU. It is mandatory to study level of sedation and associated factors on a large scale using large sample size