Comparison between the Comfort and Hartwig sedation scales in pediatric patients undergoing mechanical lung ventilation

Detalhes bibliográficos
Autor(a) principal: Carvalho,Werther Brunow de
Data de Publicação: 1999
Outros Autores: Silva,Paulo Sérgio Lucas da, Chiu,Seing Tsok Paulo, Fonseca,Marcelo Machado Cunio, Belli,Luiz Antônio
Tipo de documento: Artigo
Idioma: eng
Título da fonte: São Paulo medical journal (Online)
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31801999000500003
Resumo: CONTEXT: A high number of hospitalized children do not receive adequate sedation due to inadequate evaluation and use of such agents. With the increase in knowledge of sedation and analgesia in recent years, concern has also risen, such that it is now not acceptable that incorrect evaluations of the state of children's pain and anxiety are made. OBJECTIVE: A comparison between the Comfort and Hartwig sedation scales in pediatric patients undergoing mechanical lung ventilation. DESIGN: Prospective cohort study. SETTING: A pediatric intensive care unit with three beds at an urban teaching hospital. PATIENTS: Thirty simultaneous and independent observations were conducted by specialists on 18 patients studied. DIAGNOSTIC TEST: Comfort and Hartwig scales were applied, after 3 minutes of observation. MAIN MEASUREMENTS: Agreement rate (kappa). RESULTS: On the Comfort scale, the averages for adequately sedated, insufficiently sedated, and over-sedated were 20.28 (SD 2.78), 27.5 (SD 0.70), and 15.1 (SD 1.10), respectively, whereas on the Hartwig scale, the averages for adequately sedated, insufficiently sedated, and over-sedated were 16.35 (SD 0.77), 20.85 (SD 1.57), and 13.0 (SD 0.89), respectively. The observed agreement rate was 63% (p = 0.006) and the expected agreement rate was 44% with a Kappa coefficient of 0.345238 (z = 2.49). CONCLUSIONS: In our study there was no statistically significant difference whether the more complex Comfort scale was applied (8 physiological and behavioral parameters) or the less complex Hartwig scale (5 behavioral parameters) was applied to assess the sedation of mechanically ventilated pediatric patients.
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spelling Comparison between the Comfort and Hartwig sedation scales in pediatric patients undergoing mechanical lung ventilationSedation scaleComfort. HartwigMechanical Lung VentilationPediatric Intensive CareCONTEXT: A high number of hospitalized children do not receive adequate sedation due to inadequate evaluation and use of such agents. With the increase in knowledge of sedation and analgesia in recent years, concern has also risen, such that it is now not acceptable that incorrect evaluations of the state of children's pain and anxiety are made. OBJECTIVE: A comparison between the Comfort and Hartwig sedation scales in pediatric patients undergoing mechanical lung ventilation. DESIGN: Prospective cohort study. SETTING: A pediatric intensive care unit with three beds at an urban teaching hospital. PATIENTS: Thirty simultaneous and independent observations were conducted by specialists on 18 patients studied. DIAGNOSTIC TEST: Comfort and Hartwig scales were applied, after 3 minutes of observation. MAIN MEASUREMENTS: Agreement rate (kappa). RESULTS: On the Comfort scale, the averages for adequately sedated, insufficiently sedated, and over-sedated were 20.28 (SD 2.78), 27.5 (SD 0.70), and 15.1 (SD 1.10), respectively, whereas on the Hartwig scale, the averages for adequately sedated, insufficiently sedated, and over-sedated were 16.35 (SD 0.77), 20.85 (SD 1.57), and 13.0 (SD 0.89), respectively. The observed agreement rate was 63% (p = 0.006) and the expected agreement rate was 44% with a Kappa coefficient of 0.345238 (z = 2.49). CONCLUSIONS: In our study there was no statistically significant difference whether the more complex Comfort scale was applied (8 physiological and behavioral parameters) or the less complex Hartwig scale (5 behavioral parameters) was applied to assess the sedation of mechanically ventilated pediatric patients.Associação Paulista de Medicina - APM1999-09-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31801999000500003Sao Paulo Medical Journal v.117 n.5 1999reponame:São Paulo medical journal (Online)instname:Associação Paulista de Medicinainstacron:APM10.1590/S1516-31801999000500003info:eu-repo/semantics/openAccessCarvalho,Werther Brunow deSilva,Paulo Sérgio Lucas daChiu,Seing Tsok PauloFonseca,Marcelo Machado CunioBelli,Luiz Antônioeng1999-12-09T00:00:00Zoai:scielo:S1516-31801999000500003Revistahttp://www.scielo.br/spmjhttps://old.scielo.br/oai/scielo-oai.phprevistas@apm.org.br1806-94601516-3180opendoar:1999-12-09T00:00São Paulo medical journal (Online) - Associação Paulista de Medicinafalse
dc.title.none.fl_str_mv Comparison between the Comfort and Hartwig sedation scales in pediatric patients undergoing mechanical lung ventilation
title Comparison between the Comfort and Hartwig sedation scales in pediatric patients undergoing mechanical lung ventilation
spellingShingle Comparison between the Comfort and Hartwig sedation scales in pediatric patients undergoing mechanical lung ventilation
Carvalho,Werther Brunow de
Sedation scale
Comfort. Hartwig
Mechanical Lung Ventilation
Pediatric Intensive Care
title_short Comparison between the Comfort and Hartwig sedation scales in pediatric patients undergoing mechanical lung ventilation
title_full Comparison between the Comfort and Hartwig sedation scales in pediatric patients undergoing mechanical lung ventilation
title_fullStr Comparison between the Comfort and Hartwig sedation scales in pediatric patients undergoing mechanical lung ventilation
title_full_unstemmed Comparison between the Comfort and Hartwig sedation scales in pediatric patients undergoing mechanical lung ventilation
title_sort Comparison between the Comfort and Hartwig sedation scales in pediatric patients undergoing mechanical lung ventilation
author Carvalho,Werther Brunow de
author_facet Carvalho,Werther Brunow de
Silva,Paulo Sérgio Lucas da
Chiu,Seing Tsok Paulo
Fonseca,Marcelo Machado Cunio
Belli,Luiz Antônio
author_role author
author2 Silva,Paulo Sérgio Lucas da
Chiu,Seing Tsok Paulo
Fonseca,Marcelo Machado Cunio
Belli,Luiz Antônio
author2_role author
author
author
author
dc.contributor.author.fl_str_mv Carvalho,Werther Brunow de
Silva,Paulo Sérgio Lucas da
Chiu,Seing Tsok Paulo
Fonseca,Marcelo Machado Cunio
Belli,Luiz Antônio
dc.subject.por.fl_str_mv Sedation scale
Comfort. Hartwig
Mechanical Lung Ventilation
Pediatric Intensive Care
topic Sedation scale
Comfort. Hartwig
Mechanical Lung Ventilation
Pediatric Intensive Care
description CONTEXT: A high number of hospitalized children do not receive adequate sedation due to inadequate evaluation and use of such agents. With the increase in knowledge of sedation and analgesia in recent years, concern has also risen, such that it is now not acceptable that incorrect evaluations of the state of children's pain and anxiety are made. OBJECTIVE: A comparison between the Comfort and Hartwig sedation scales in pediatric patients undergoing mechanical lung ventilation. DESIGN: Prospective cohort study. SETTING: A pediatric intensive care unit with three beds at an urban teaching hospital. PATIENTS: Thirty simultaneous and independent observations were conducted by specialists on 18 patients studied. DIAGNOSTIC TEST: Comfort and Hartwig scales were applied, after 3 minutes of observation. MAIN MEASUREMENTS: Agreement rate (kappa). RESULTS: On the Comfort scale, the averages for adequately sedated, insufficiently sedated, and over-sedated were 20.28 (SD 2.78), 27.5 (SD 0.70), and 15.1 (SD 1.10), respectively, whereas on the Hartwig scale, the averages for adequately sedated, insufficiently sedated, and over-sedated were 16.35 (SD 0.77), 20.85 (SD 1.57), and 13.0 (SD 0.89), respectively. The observed agreement rate was 63% (p = 0.006) and the expected agreement rate was 44% with a Kappa coefficient of 0.345238 (z = 2.49). CONCLUSIONS: In our study there was no statistically significant difference whether the more complex Comfort scale was applied (8 physiological and behavioral parameters) or the less complex Hartwig scale (5 behavioral parameters) was applied to assess the sedation of mechanically ventilated pediatric patients.
publishDate 1999
dc.date.none.fl_str_mv 1999-09-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31801999000500003
url http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31801999000500003
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 10.1590/S1516-31801999000500003
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv text/html
dc.publisher.none.fl_str_mv Associação Paulista de Medicina - APM
publisher.none.fl_str_mv Associação Paulista de Medicina - APM
dc.source.none.fl_str_mv Sao Paulo Medical Journal v.117 n.5 1999
reponame:São Paulo medical journal (Online)
instname:Associação Paulista de Medicina
instacron:APM
instname_str Associação Paulista de Medicina
instacron_str APM
institution APM
reponame_str São Paulo medical journal (Online)
collection São Paulo medical journal (Online)
repository.name.fl_str_mv São Paulo medical journal (Online) - Associação Paulista de Medicina
repository.mail.fl_str_mv revistas@apm.org.br
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