Sedation and neuromuscular blockade in paediatric intensive care: a review of current practice in the UK.
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.
Playfor
Stephen D
SD
Paediatric Intensive Care Unit, Royal Manchester Children's Hospital, Hospital Road, Pendlebury, Manchester M27 4HA, UK. playfor@hotmail.com
Thomas
David A
DA
Choonara
Imti
I
D002648:Child; D002675:Child, Preschool; D016292:Procedural Sedation; D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D015278:Intensive Care Units, Pediatric / Q000706:statistics & numerical data*; D008297:Male; D019148:Neuromuscular Blockade; D009466:Neuromuscular Blocking Agents / Q000627:therapeutic use*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D006113:United Kingdom
D006993:Hypnotics and Sedatives; D009466:Neuromuscular Blocking Agents