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Limited professional guidance and literature are available to guide the safe use of neuromuscular block in infants
Author(s) -
Honsel Maik,
Giugni Cristina,
Brierley Joe
Publication year - 2014
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.12682
Subject(s) - medicine , protocol (science) , neuromuscular blocking agents , telephone survey , peripheral nerve stimulation , clinical practice , telephone interview , intensive care medicine , pediatrics , physical therapy , anesthesia , alternative medicine , stimulation , social science , pathology , marketing , sociology , business
Aim Neuromuscular blocking agents ( NMBA s) are used in a range of critical illnesses in neonates and infants, despite a lack of guidelines and professional standards. This study reviewed the current evidence base and ascertained UK practice regarding the continuous use of these agents in this age range. Methods We reviewed the literature and carried out a telephone questionnaire of all tertiary units in England and specialist children's hospital neonatal units in the UK . Results No best practice guidelines or general consensus statements were found, and the only randomised trial to feature an NMBA protocol expressed concerns about its use in such young babies. Of the 56 units contacted, 54 (96.4%) shared information. Only three of the 56 (5.4%) used intermittent boluses of NMBA s, 91.1% used NMBA infusions, 11 (19.6%) routinely used regular neuromuscular blocker pause to assess depth, and only one (1.8%) used peripheral nerve stimulation monitoring. All the units carried out clinical assessments, but only one (1.8%) had a written protocol. Conclusion There is a paucity of literature and professional standards to guide the safe use of NMBA s in infants. Of the 54 units who participated in the survey, only one had a protocol for using NMBA s in babies.