Stephen D Playfor1, David A Thomas, Imti Choonara. 1. Paediatric Intensive Care Unit, Royal Manchester Children's Hospital, Hospital Road, Pendlebury, Manchester M27 4HA, UK. playfor@hotmail.com
Abstract
BACKGROUND: Our aim was to investigate the current practice of sedation and neuromuscular blockade in critically ill children in paediatric intensive care units (PICUs) in the UK. METHODS: A postal questionnaire was sent to all PICUs in the UK. RESULTS: The most commonly used sedative agents were midazolam in combination with morphine. Written clinical guidelines for the sedation of critically ill children were available in 45% of units. Sedation is formally assessed in 40% of units. Vecuronium is the most commonly used neuromuscular blocking agent. In the UK, 31% of critically ill children are likely to receive neuromuscular blocking agents. Depth of neuromuscular blockade is routinely assessed in 16% of patients. CONCLUSIONS: Relatively few units possess clinical guidelines for the sedation of critically ill children, and only a minority formally assess sedation levels. Where neuromuscular blocking agents are administered, sedation is frequently inadequately assessed and the depth of neuromuscular blockade is rarely estimated.
BACKGROUND: Our aim was to investigate the current practice of sedation and neuromuscular blockade in critically ill children in paediatric intensive care units (PICUs) in the UK. METHODS: A postal questionnaire was sent to all PICUs in the UK. RESULTS: The most commonly used sedative agents were midazolam in combination with morphine. Written clinical guidelines for the sedation of critically ill children were available in 45% of units. Sedation is formally assessed in 40% of units. Vecuronium is the most commonly used neuromuscular blocking agent. In the UK, 31% of critically ill children are likely to receive neuromuscular blocking agents. Depth of neuromuscular blockade is routinely assessed in 16% of patients. CONCLUSIONS: Relatively few units possess clinical guidelines for the sedation of critically ill children, and only a minority formally assess sedation levels. Where neuromuscular blocking agents are administered, sedation is frequently inadequately assessed and the depth of neuromuscular blockade is rarely estimated.
Authors: Ari R Joffe; Jessica Hogan; Cathy Sheppard; Gerda Tawfik; Jonathan P Duff; Gonzalo Garcia Guerra Journal: Crit Care Date: 2017-11-26 Impact factor: 9.097