title: Outcomes following neuromuscular blockade in patients receiving tracheostomies.
abstract: OBJECTIVE
  The purpose of this study is to determine whether the use of neuromuscular blockade agents (NMBAs) in pediatric patients following tracheostomy is associated with increased rates of complications or a prolonged length of stay.
  
  
  METHODS
  This was a single-center retrospective chart review of pediatric patients undergoing tracheostomy placement between 2010 and 2013 who were admitted to the pediatric or neonatal intensive care units and did or did not receive NMBA within 7 days post-procedure.
  
  
  RESULTS
  Out of 114 included patients, 26 (23%) received NMBAs during the postoperative period. Patients receiving NMBAs were more likely to have cardiac disease and preoperative respiratory failure but less likely to have neurologic disease. Patients receiving NMBAs had a longer median postoperative length of stay (33 vs. 23 days, p=0.043) and were more likely to have postoperative ileus (12% vs. 3%, p=0.037).
  
  
  CONCLUSIONS
  In patients undergoing tracheostomy placement, use of NMBAs is associated with prolonged postoperative hospital courses. NMBAs are not associated with a higher likelihood of postoperative complications.
authors.affiliation: The Ohio State University College of Medicine, Columbus, OH, United States.
authors.forename: Eric
authors.initials: E
authors.lastname: Bauer
authors.affiliation: Center for Surgical Outcomes Research, The Research Institute at Nationwide Children's Hospital, Columbus, OH, United States; Division of Pediatric Surgery, Nationwide Children's Hospital, Columbus, OH, United States.
authors.forename: Justin B
authors.initials: JB
authors.lastname: Mahida
authors.affiliation: Division of Pediatric Surgery, Nationwide Children's Hospital, Columbus, OH, United States.
authors.forename: Laura A
authors.initials: LA
authors.lastname: Boomer
authors.affiliation: Division of Critical Care Medicine, Nationwide Children's Hospital, Columbus, OH, United States; Department of Pediatric Otolaryngology, Nationwide Children's Hospital, Columbus, OH, United States.
authors.forename: Jeffrey E
authors.initials: JE
authors.lastname: Lutmer
authors.affiliation: Center for Surgical Outcomes Research, The Research Institute at Nationwide Children's Hospital, Columbus, OH, United States; Division of Pediatric Surgery, Nationwide Children's Hospital, Columbus, OH, United States.
authors.forename: Peter C
authors.initials: PC
authors.lastname: Minneci
authors.affiliation: Center for Surgical Outcomes Research, The Research Institute at Nationwide Children's Hospital, Columbus, OH, United States; Division of Pediatric Surgery, Nationwide Children's Hospital, Columbus, OH, United States.
authors.forename: Katherine J
authors.initials: KJ
authors.lastname: Deans
authors.affiliation: Division of Critical Care Medicine, Nationwide Children's Hospital, Columbus, OH, United States; Department of Pediatric Otolaryngology, Nationwide Children's Hospital, Columbus, OH, United States. Electronic address: charles.elmaraghy@nationwidechildrens.org.
authors.forename: Charles A
authors.initials: CA
authors.lastname: Elmaraghy
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D019148:Neuromuscular Blockade / Q000009:adverse effects*; D017063:Outcome Assessment, Health Care; D011182:Postoperative Care / Q000009:adverse effects* / Q000379:methods; D011183:Postoperative Complications / Q000209:etiology*; D012189:Retrospective Studies; D014139:Tracheostomy
keywords: Neuromuscular blockade; Pediatric intensive care; Tracheostomy