Short-Term Health-Related Quality of Life of Critically Ill Children Following Daily Sedation Interruption

• Published in: Pediatric critical care medicine Vol. 17; no. 11; pp. e513 - e520
• Main Authors: Vet, Nienke J, de Wildt, Saskia N, Verlaat, Carin W M, Mooij, Miriam G, Tibboel, Dick, de Hoog, Matthijs, Buysse, Corinne M P
• Format: Journal Article
• Language: English
• Published: United States 01-11-2016
• Subjects: Adolescent; Child; Child, Preschool; Clinical Protocols; Critical Care - methods; Critical Illness; Deep Sedation - methods; Female; Follow-Up Studies; Health Status Indicators; Humans; Hypnotics and Sedatives - administration & dosage; Hypnotics and Sedatives - therapeutic use; Infant; Infant, Newborn; Male; Midazolam - administration & dosage; Midazolam - therapeutic use; Prospective Studies; Quality of Life; Respiration, Artificial; Stress Disorders, Post-Traumatic - diagnosis; Stress Disorders, Post-Traumatic - etiology; Stress Disorders, Post-Traumatic - prevention & control; Treatment Outcome
• ISSN: 1529-7535
• DOI: 10.1097/PCC.0000000000000956

Our earlier pediatric daily sedation interruption trial showed that daily sedation interruption in addition to protocolized sedation in critically ill children does not reduce duration of mechanical ventilation, length of stay, or amounts of sedative drugs administered when compared with protocolized sedation only, but undersedation was more frequent in the daily sedation interruption + protocolized sedation group. We now report the preplanned analysis comparing short-term health-related quality of life and posttraumatic stress symptoms between the two groups.
Preplanned prospective part of a randomized controlled trial.
Two tertiary medical-surgical PICUs in the Netherlands.
Critically ill children requiring mechanical ventilation.
None.
Eight weeks after a child's discharge from the PICU, health-related quality of life was assessed with the validated Child Health Questionnaire and, only for children above 4 years old, posttraumatic stress was assessed with the Dutch Children's Responses to Trauma Inventory. Additionally, health-related quality of life of all study patients was compared with Dutch normative data. Of the 113 patients from two participating centers in the original study, 96 patients were eligible for follow-up and 64 patients were included (response rate, 67%). No difference was found with respect to health-related quality of life between the two study groups. None of the eight children more than 4 years old showed posttraumatic stress symptoms.
Daily sedation interruption in addition to protocolized sedation for critically ill children did not seem to have an effect on short-term health-related quality of life. Also in view of the earlier found absence of effect on clinical outcome, we cannot recommend the use of daily sedation interruption + protocolized sedation.