{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T07:03:02Z","timestamp":1779692582096,"version":"3.53.1"},"reference-count":26,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T00:00:00Z","timestamp":1779667200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In mechanically ventilated children in the PICU, assessment of analgesia, sedation, and delirium often requires multiple instruments, which increases workflow complexity and nursing burden.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the association and clinical agreement between the State Behavioral Scale (SBS) and the Richmond Agitation-Sedation Scale (RASS) in mechanically ventilated children in the PICU.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective study included 1,025 mechanically ventilated children admitted to a tertiary PICU between May 2024 and October 2025. SBS and RASS scores were recorded simultaneously at predefined time points, resulting in 13,736 paired observations. Patient-level clustering caused by repeated measurements was addressed using cluster-robust standard errors and generalized estimating equations (GEE).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Spearman rank correlation analysis with patient-level cluster-robust standard errors showed a strong positive association between RASS and SBS scores (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.857, 95% CI: 0.841\u20130.873,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001). Linear weighted kappa demonstrated good agreement (weighted kappa\u2009=\u20090.821, 95% CI: 0.802\u20130.840), and the GEE-adjusted robust coefficient remained stable (0.849, 95% CI: 0.833\u20130.865,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001). In a nurse survey, 64.7% reported that RASS was more convenient and faster to use, and 54.9% considered it more reflective of clinical status.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>RASS showed good clinical agreement with SBS in mechanically ventilated children and may serve as a practical and efficient alternative for sedation assessment in the PICU, provided that standardized training and local implementation procedures are ensured.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2026.1829799","type":"journal-article","created":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T06:06:33Z","timestamp":1779689193000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparative evaluation of SBS and RASS for sedation assessment in mechanically ventilated children"],"prefix":"10.3389","volume":"14","author":[{"given":"Dan","family":"Li","sequence":"first","affiliation":[{"name":"Department of Critical Care Medicine, Children\u2019s Hospital of Chongqing Medical University, National Clinical Research Center for Children and Adolescents\u2019 Health and Diseases, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Neurodevelopment and Cognitive Disorders","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shan","family":"He","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Children\u2019s Hospital of Chongqing Medical University, National Clinical Research Center for Children and Adolescents\u2019 Health and Diseases, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Neurodevelopment and Cognitive Disorders","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Children\u2019s Hospital of Chongqing Medical University, National Clinical Research Center for Children and Adolescents\u2019 Health and Diseases, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Neurodevelopment and Cognitive Disorders","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Children\u2019s Hospital of Chongqing Medical University, National Clinical Research Center for Children and Adolescents\u2019 Health and Diseases, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Neurodevelopment and Cognitive Disorders","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ping","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Children\u2019s Hospital of Chongqing Medical University, National Clinical Research Center for Children and Adolescents\u2019 Health and Diseases, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Neurodevelopment and Cognitive Disorders","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,25]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"196","DOI":"10.3760\/cma.j.cn112140-20231130-00400","article-title":"Chinese expert consensus on analgesia and sedation therapy in pediatric intensive care units","volume":"62","year":"2024","journal-title":"Chin J 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