Oversedation of mechanically ventilated children is common in many pediatric intensive care units (PICUs). This practice is driven by the challenges of dealing with children of different ages as they have different behavioral, mental, and emotional statuses. We aimed to evaluate the effect of implementing a target-driven sedation protocol in the PICU on ventilator-free days (VFDs), PICU stays, and hospitalization. A 2-year retrospective cohort study was performed in our PICU between October 1, 2018, and October 1, 2020. All intubated children up to 12 years of age were included. Descriptive analyses and a pre- and postintervention comparison of VFDs and length of stay were used to assess the protocol's effectiveness. A total of 134 patients were studied. There was a significant increase in VFDs in cases with respiratory illness requiring mechanical ventilation after implementing this protocol (19.9 vs. 22.3, respectively, with a p-value of 0.031). Also, there was a trend of reduction in the length of PICU stay (median of 9 vs. 8 days, p = 0.816), post-PICU length of stay (median of 4 vs. 3 days, p = 0.055), and hospitalization duration (median of 16 vs. 13 days, p = 0.062) though not statistically significant. Implementing a target-driven sedation protocol in the PICU significantly affects VFDs in mechanically ventilated respiratory cases. Though inconclusive in our study, implementing such a protocol will influence patients' care and reduce unnecessary sedation uses that will reduce sedation hazards.

A.A. contributed to conceptualization, methodology, investigation, data curation, writing—original draft, and supervision. A.A., M.S., M.B., and M.E. helped in investigation—data collection, writing—review and editing.

Received: 18 July 2023

Accepted: 04 August 2023

Article published online:
19 September 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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