Neuromuscular blockade Pediatric intensive care unit Neuromuscular blocking agents Neuromuscular monitoring
Conditions
Interventions
Patient receives train-of-four test at ulnar nerve in the morning and in the evening. The test result is revealed to the physician in charge. Train-of-four test result, together with clinical assessme
s movement, are used for titration of cisatracurium dose.,Patient receives train-of-four test at ulnar nerve in the morning and in the evening. The test result is CONCEALED from the clinical team. Onl
s movement is used for titration of cisatracurium dose.
Experimental Device,No Intervention No treatment
Train-of-four monitoring with clinical assessment,Clinical assessment alone
Sponsors
Dr. Suvikrom Law
Dr. Thakoon Butpech
Eligibility
Sex/Gender
All
Age
1 Months to 18 Years
Inclusion criteria
Inclusion criteria: 1. Patients admitted to PICU 2. Plan to receive continuous IV cisatracurium infusion for at least 2 days
Exclusion criteria
Exclusion criteria: 1. Known or suspected neuromuscular disease 2. Fracture of both hands or wrists 3. Allergic to cisatracurium or atracurium 4. Patient having medical devices on both hands that preclude TOF testing 5. Patient having permanent or temporary cardiac pacemaker
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Total daily cisatracurium dose From 7am to 7am the next day Total daily cisatracurium dose measured in mg with one decimal point | — |
Secondary
| Measure | Time frame |
|---|---|
| Train-of-four result Twice per day, in the morning and evening of each day Train-of-four test at ulnar nerve measured as number of twitches (0, 1, 2, 3, or 4 twitches),Clinical assessment of neuromuscular blockade depth Twice per day, in the morning and evening of each day Clinical assessment of patient's movement, ventilator synchrony/triggering, cough and gag; categorized as over-paralyzed, well-paralyzed and under-paralyzed.,Total daily sedative dose from 7am to 7 am the next day Total daily sedative dose measured in mg or micrograms as appropriate | — |
Countries
Thailand
Contacts
Public ContactSuvikrom Law
Faculty of Medicine Siriraj Hospital, Mahidol University
Outcome results
None listed