ĐẶC ĐIỂM SỬ DỤNG THUỐC AN THẦN VÀ GIẢM ĐAU Ở BỆNH NHI THỞ MÁY TẠI BỆNH VIỆN NHI TRUNG ƯƠNG

Abstract

The study aimed to describe the current practice of sedation and analgesia in children on mechanical ventilation at the Pediatric Intensive Care Unit, Vietnam National Children’s Hospital. This was a cross-sectional descriptive study conducted on all children aged 3 months to less than 18 years, requiring mechanical ventilation for at least 48 hours, between October 2024 and April 2025. A total of 123 children were enrolled, with a median age of 15 months (IQR: 3–40). Of these, 21.1% had a history of preterm birth and 13.8% had a history of prolonged sedation/ analgesia. 40% had chronic underlying diseases. Midazolam was the most frequently used sedative (98.4%); while Fentanyl was the most commonly used analgesic (96.7%). The most common sedation–analgesia therapy was continuous midazolam infusion combined with continuous fentanyl infusion (76.4%). The median duration of midazolam and fentanyl administration was 7 days (IQR: 4-10, range: 1–43 days). At 48 hours of mechanical ventilation, the proportion of children was sedated at the deep level was high (52.8%), while 46.3% had moderate to light sedation. Factors associated with deep sedation included history of prematurity, history of prolonged sedation/analgesia, use of high-frequency oscillatory ventilation (HFOV), vasopressor therapy, and renal replacement therapy.