None of the patients involved in this study developed any complications throughout the process of procedural sedation.
Initially, the trainees were instructed to understand indications, processes of procedures, medication of sedation, and descriptions of findings followed by observation of colonoscopy performed by the faculty member or professor for 2 weeks.
This methodology is used with success in other medical areas and briefly consists of understanding what are the characteristics of patients (e.g., case-mix, severity, etiology of ARF), structure (e.g., staffing patterns, types of ICU) and processes of care (e.g., sedation practices, weaning protocols, ventilator settings) of those that achieve better results.
The present quality improvement process was the third quality process performed in the ICU regarding the management of sedation and analgesia.
Prospective research is needed to determine the optimal conditions for Chinese patients including indications, decision making process, informed consent, cultural and ethical issues, type of sedation and drugs.
The bispectral index (BIS) is a processed neurophysiological electroencephalographic parameter that may be used to evaluate the depth of sedation in critically ill children.
These monitors process data through various proprietary algorithms to a dimensionless number that reflects the depth of sedation of the brain.
Given that the poor quality of sedation and difficulties in reaching and maintaining sedation targets cannot be resolved with currently available processed EEG methods or scores, how to achieve optimal sedation remains a major problem in the ICU.
ACKBA was involved in the design of the database to measure compliance with processes of care, survey of barriers to adoption of minimal sedation, redesign of the protocol for minimizing sedation, linking and analyzing the databases, and writing the manuscript.
"They all had a risk of sedation, and by combining all these medications, the sedation was substantial enough that it was lethal".
