Paediatric anaesthesia & critical care
Adherence to Sedative Weaning Opportunities and Length of Stay for Critically Ill Children
Authors' conclusion
In this multicenter cohort, adherence to sedative weaning opportunities was low. Higher weaning adherence was independently associated with shorter ICU and hospital lengths of stay and reduced sedative exposure.
Study context
- Population
- Pediatric ICU patients with >48 hours of cumulative sedative infusion exposure, 4 pediatric academic centers, 2011–2024 (neonatal ICU stays excluded)ICU encounters from 12,737 patients
- Participants
- 15,747 patients
- Exposure
- Association of sedative weaning adherence with outcomes
- Outcome
- ICU and hospital LOS
Methodological detailsmulticenter, 4 pediatric academic medical centers, multivariable linear regression adjusted for center, age, and sex
- Multicenter
- 4 pediatric academic medical centers
- Multivariable linear regression adjusted for center, age, and sex
Main finding
As reported in the abstract
Median ICU LOS change per 10% increase in adherence (IQR −2.4 to −2.2 days; P < .001)
−2.3 days
Median total hospital LOS change per 10% increase in adherence (IQR −4.0 to −3.4 days; P < .001)
−3.6 days
Observational data: associations, not effects.
Secondary outcomes
Weaning adherence (descriptive)
- Median opportunities to wean per ICU encounter (IQR 13-68)
- 30
- Overall adherence to weaning opportunities (IQR 14%-49%)
- 28%
- Missed weaning opportunities, median (IQR 51%-86%)
- 72%
- Median ICU LOS (IQR 7-25 days)
- 13 days
- Median hospital LOS (IQR 14-55 days)
- 26 days
Sedative infusion duration, all classes, per 10% increase in adherence
- Median change (IQR −1.2 to −1.0 days; P < .001)
- −1.1 days
Cumulative sedative exposure
- Opioids, median change (IQR −3.8 to −3.2 mg/kg; P < .001)
- −3.5 mg/kg
- Benzodiazepines, median change (IQR −3.8 to −3.0 mg/kg; P < .001)
- −3.4 mg/kg
- α2 agonists, median change (IQR −30.2 to −25.3 µg/kg; P < .001)
- −27.7 µg/kg
Original publication
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