Clinical practice guidelines for sustained neuromuscular blockade in the adult critically ill patient: 2016 update—executive summary

Abstract

These guidelines update the 2002 version of “Clinical Practice Guidelines for Sustained Neuromuscular Blockade in the Adult Critically Ill Patient.” A task force comprising 17 members of the Society of Critical Care Medicine (SCCM) with particular expertise in the use of neuromuscular blocking agents (NMBAs); a Grading of Recommendations Assessment, Development, and Evaluation (GRADE) expert; and a medical writer met via teleconference and three face-to-face meetings and communicated via e-mail to examine the evidence and develop these practice guidelines. Annually, all members completed conflict-of-interest statements; no conflicts were identified. This activity was funded by SCCM, and no industry support was provided. Using the GRADE system, the GRADE expert on the task force created profiles for the evidence related to 6 of the 21 questions and assigned quality-of-evidence scores to these and the additional 15 questions for which insufficient evidence was available to create a profile. Task force members reviewed this material and all available evidence and provided recommendations, suggestions, or good practice statements for these 21 questions.