镇静深度与危重症患儿预后的关系

Relationship between sedation depth and prognosis of critically ill children

儿童重症监护病房(PICU)患儿处于强烈的应激环境中,此时交感神经易过度兴奋而产生“交感风暴”,从而导致一系列并发症,因此镇静镇痛治疗是危重症患儿治疗的重要组成部分。对于镇静深度的选择及镇静评估的相关方法,成人已有较多临床文献及指南支持,但儿童这方面高质量临床证据尚不足。因此,本文主要探讨不同镇静深度与危重症患儿预后的关系,并结合成人相关指南及现有文献对镇静深度的定义、选择及评估进行概述。

As the children in the paediatric intensive care unit(PICU)are in a strong stress environment,sympathetic nerves are prone to overexcitation and produce a“sympathetic storm”,which leads to a series of complications.Therefore,the treatment of sedation and analgesia is an important for critically ill children.There are a large number of clinical literature and guidelines supporting the selection of sedation depth and sedation evaluation methods in adults,but the high-quality clinical evidence in children is still insufficient.Thus,this review mainly discusses the relationship between different sedation depths and the prognosis of critically ill children,and will summarize the definition,selection and evaluation of sedation depth based on adult guidelines and existing literature.