Abstract
Objectives: To examine the trends of continuous neuromuscular blocking agent (NMBA) use in our PICU. Methods: We retrospectively examined 84 critically ill children who were managed with continuous NMBA using vecuronium bromide (Vb) in the PICU between January 2010 and December 2012. The children were divided into 7 groups according to the indications for continuous NMBA. We retrospectively investigated the duration of Vb administration, total Vb dose, and period from Vb discontinuation to extubation. Results: Among all the children who were put on mechanical ventilation, Vb was continuously administered in 84 (10.5%; median age, 2 months). Continuous NMBA was introduced for the following indications: (1) prevention of pulmonary hypertension (33 cases; median duration of NMBA, 43 hr); (2) protective lung ventilation (16 cases; median duration, 72 hr); (3) protection of surgical anastomosis (12 cases; median duration, 112 hr); (4) prevention of intra-abdominal hypertension (9 cases; median duration, 63 hr), (5) prevention of shivering during therapeutic hypothermia (5 cases; median duration, 116 hr); (6) prevention of tracheal bleeding (5 cases; median duration, 93 hr); and (7) other reasons (4 cases; median duration, 133 hr). Conclusion: No criteria governed the start or discontinuance of NMBA in each group. Further studies are required to investigate the effects of continuous NMBA on the mortality and morbidity rates of critically ill children managed with this approach.
