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Rev Bras Ter Intensiva. 2013 Oct-Dec;25(4):306-11. doi: 10.5935/0103-507X.20130052.

A comparison of gradual sedation levels using the Comfort-B scale and bispectral index in children on mechanical ventilation in the pediatric intensive care unit.

[Article in English, Portuguese]

Author information

  • 1Hospital das Clínicas de Porto Alegre, Unidade de Terapia Intensiva Pediátrica, Porto AlegreRS, Brasil, Unidade de Terapia Intensiva Pediátrica, Hospital das Clínicas de Porto Alegre - HCPA - Porto Alegre (RS), Brasil.
  • 2Hospital das Clínicas de Porto Alegre, Serviço de Pediatria, Porto AlegreRS, Brasil, Serviço de Pediatria, Hospital das Clínicas de Porto Alegre - HCPA - Porto Alegre (RS), Brasil.
  • 3Universidade Federal do Rio Grande do Sul, Porto AlegreRS, Brasil, Universidade Federal do Rio Grande do Sul - UFRGS - Porto Alegre (RS), Brasil.
  • 4Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Departamento de Pediatria, Porto AlegreRS, Brasil, Departamento de Pediatria, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul - UFRGS - Porto Alegre (RS), Brasil.

Abstract

OBJECTIVE:

Compare the scores resulting from the Comfort-B scale with the bispectral index in children in an intensive care unit.

METHODS:

Eleven children between the ages of 1 month and 16 years requiring mechanical ventilation and sedation were simultaneously classified based on the bispectral index and the Comfort-B scale. Their behavior was recorded using digital photography, and the record was later evaluated by three independent evaluators. Agreement tests (Bland-Altman and Kappa) were then performed. The correlation between the two methods (Pearson correlation) was tested.

RESULTS:

In total, 35 observations were performed on 11 patients. Based on the Kappa coefficient, the agreement among evaluators ranged from 0.56 to 0.75 (p<0.001). There was a positive and consistent association between the bispectral index and the Comfort-B scale [r=0.424 (p=0.011) to r=0.498 (p=0.002)].

CONCLUSION:

Due to the strong correlation between the independent evaluators and the consistent correlation between the two methods, the results suggest that the Comfort-B scale is reproducible and useful in classifying the level of sedation in children requiring mechanical ventilation.

PMID:
24553512
PMCID:
PMC4031876
DOI:
10.5935/0103-507X.20130052
[PubMed - indexed for MEDLINE]
Free PMC Article
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