Abstract 1482

BACKGROUND: The use of sedation and paralysis in babies requiring assisted ventilation is controversial. Yet, little information is available on the prevalence of sedative and paralytic use in NICUs.

METHODS: We analyzed data from 7,535 patients requiring assisted ventilation who were admitted to 17 NICUs in the Canadian NICU Network from Jan 1996 to Oct 1997. Patients were stratified by birthweight, and mean days on assisted ventilation was determined for each group. Use of narcotics (N), benzodiazepines (B) and pancuronium (P) are shown in the Table below. The most commonly used narcotics were morphine (73.8%), fentanyl (39.6%) and multiple agents (23.6%). Most commonly used benzodiapepines were midazolam (62%), lorazepam (35.6%) and multiple agents (18.2%). 97.9% of all babies who received Pancuronium also received narcotics or benzodiazepines for sedation.

Table 1 No caption available
Full size table

CONCLUSIONS: Larger babies requiring assisted ventilation are more likely to receive sedation or paralytics. Almost all babies receiving paralytics are sedated, primarily with narcotics. Use of multiple sedative agents is common. Significant variability suggests that indications and preferred medications for babies with assisted ventilation warrant further investigation.

Funded by the Medical Research Council of Canada