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Consensus guidelines for sustained neuromuscular blockade in critically ill children

Stephen Playfor1, Ian Jenkins, Carolyne Boyles

  • 1Paediatric Intensive Care Unit, Royal Manchester Children's Hospital, Pendlebury, Manchester, UK. stephen.playfor@cmmc.nhs.uk

Paediatric Anaesthesia
|August 9, 2007
PubMed

Insights

This study provides the first consensus guidelines for neuromuscular blockade in critically ill children, addressing a gap in pediatric intensive care. Further research is needed due to limited high-quality evidence.

Area of Science:

  • Pediatric Critical Care Medicine
  • Clinical Practice Guidelines

Background:

  • Established adult guidelines exist for neuromuscular blockade in critical care.
  • No prior clinical practice guidelines were available for critically ill pediatric patients.

Framework:

  • A multidisciplinary expert panel, the UK Paediatric Intensive Care Society Sedation, Analgesia and Neuromuscular Blockade Working Group, was formed.
  • Consensus guidelines were developed for sedation, analgesia, and neuromuscular blockade.

Implementation:

  • A modified Delphi technique was utilized for anonymous deliberation on draft recommendations.
  • Four consensus conferences supported the Delphi process, followed by a systematic literature review.

Implications:

  • Developed consensus guidelines for maintenance neuromuscular blockade in critically ill children (excluding neonates).
  • Highlighted the scarcity of high-quality evidence, emphasizing the need for future randomized clinical trials.
Abstract

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