HK J Paediatr (new series) 2005;10:189-195 Measuring the Sedation Level of Mechanically Ventilated Infants by a Modified COMFORT Scale

Abstract This prospective observational study aimed to measure the internal consistency and inter-rater agreement of the modified COMFORT scale for mechanically ventilated patients in a neonatal intensive care unit. A sample of 15 infants requiring mechanical ventilation, generating a total of 27 observations, was recruited. Three different observers including a doctor, a nurse and a senior nurse independently assessed the sedation level of each patient. The measurement tool was modified from the original COMFORT scale. The Spearman's correlation coefficients for the inter-rater agreement between doctors and senior nurses, doctors and nurses as well as nurses and senior nurses on the total scores were 0.760, 0.626 and 0.776 respectively, all p<0.05. The reliability coefficient alpha for the internal consistency was 0.804. We suggest that the modified COMFORT scale may be an appropriate tool to observe sedation level for mechanically ventilated infants. More studies may be required for validation and outcome assessment. Key words Neonatal intensive care; Scale; Sedatives; Ventilation extubation was also found to be associated with under-sedation.4-9 On the other hand, potential risks of sedative medications were present. They included cardiovascular effects and drug interaction which might be more prominen