Quality of sedation during mechanical ventilation

The aim of the study was to determine the quality of sedation in ventilated patients on a general paediatric intensive care unit (PICU), including tho se treated with infusions of neuromuscular blocking agents. Twenty-eight ve ntilated children on a PICU had their level of sedation determined using an arousability scale dependent upon the response to tracheal suction. Observ ed levels of sedation were then compared to a predetermined desired level o f sedation. A total of 81 assessments were performed and 90% were considere d satisfactory. Thirty-two of these assessments were performed in 15 childr en following the temporary discontinuation of infusions of neuromuscular bl ocking agents; 97% of these assessments were considered satisfactory. A reg ime of continuous intravenous midazolam and morphine with additional oral s edation using chloral hydrate and antihistamines when required provides a s atisfactory level of sedation for the majority of children ventilated on a PICU, including those treated with infusions of neuromuscular blocking agen ts.