20.500.12556/DiRROS-29000 Assessment of sedation in mechanically ventilated children with severe acute bronchiolitis: correlation between COMFORT-B scale and Bispectral Index during continuous infusion of fentanyl and midazolam Background and Objectives: Analgesia and sedation are a major challenge in pediatric intensive care. The COMFORT-B scale and the Bispectral Index (BIS) are commonly used to assess the degree of sedation. The aim of this study was to investigate the correlation between the COMFORT-B and BIS and to evaluate the predictive validity of the BIS scale. Materials and Methods: Mechanically ventilated children (n = 41) diagnosed with acute bronchiolitis and treated with fentanyl and midazolam were included in the study. COMFORT-B and BIS scores were recorded over a 7-day observation period. Patients were divided into subgroups based on chronological age, neuromuscular blocker use, and level of sedation. Statistical analyses included correlation analysis by subject and time, simple moving average trend analysis, linear mixed-effects modeling and random forest. Results: Conventional correlation analysis revealed a weak to moderate correlation between the two scales in the entire cohort (Spearman rho of patients’ means 0.42, p = 0.007). The longitudinal correlation analysis by individual patient showed no significant relationship between the two scales in the entire cohort (CCF 0-lag 0.23; p = 0.33) or any subgroup. Linear mixed-effects model analysis showed that BIS score was associated with COMFORT-B score (slope = 0.799, p = 0.0002). The random forest model explained 19.6% of the variance. Both models yielded similar prediction errors (RMSE 10.6 and 11.3, respectively). Conclusions: We found a weak correlation between the two scales, which does not allow for reliable and valid predictions between the two scales. The BIS scale is suitable for the assessment of deep sedation, whereas the COMFORT-B scale is suitable for the assessment of moderate sedation. analgesia sedation fentanyl midazolam COMFORT-B bispectral index correlation analgezija sedacija fentanil midazolam COMFORT-B bispektralni indeks korelacija true false true Angleški jezik Slovenski jezik Neznano 2026-04-16 09:57:09 2026-04-16 09:57:09 2026-04-17 03:55:04 0000-00-00 00:00:00 2025 0 0 Nasl. z nasl. zaslona; Opis vira z dne 3. 11. 2025; 1-14 str. iss. 11, [article] 1953 Vol. 61 Oct. 2025 0000-00-00 Zaloznikova Objavljeno NiDoloceno 0000-00-00 0000-00-00 0000-00-00 681.5:616-089.5-053.2 1648-9144 10.3390/medicina61111953 255603459 RAZ_Jozef_Maj_2025.pdf RAZ_Jozef_Maj_2025.pdf 1 9C0787954E93093A0EC38A3B81FB8C05 92d267e7f56dbd4bd37256ed1ca3fc3504a54526e9ce7386663e49a87a20ba23 ffa5fea6-3969-11f1-9cc3-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=43288 https://www.mdpi.com/1648-9144/61/11/1953 1 dff45876-3969-11f1-9cc3-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=43287 Univerzitetni klinični center Ljubljana 0 0 0