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George Benzing III, MD; Kevin E. Bove, MD
Children's Hospital Medical Center Cincinnati, Ohio

JAMA. 1992;267(13):1775.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.

—In a recent report, Hansen-Flaschen et al¹ discussed the results of their survey of 164 hospitals regarding the "Use of Sedating Drugs and Neuromuscular Blocking Agents in Patients Requiring Mechanical Ventilation for Respiratory Failure." They reported that neuromuscular blocking agents were used in the treatment of respiratory failure in 98% of the hospitals surveyed. The authors expressed concerns about "how little guidance" can be found in the current literature.

We and others have described^2,3 terminal motor axonal neuropathy, motor end-plate changes, and muscle atrophy following prolonged use of neuromuscular-blocking agents. We observed a prolonged myasthenic syndrome after 1 week of neuromuscular blockade in a 28-month-old boy. He required brief additional respirator support because of muscular weakness. Electrodiagnostic studies showed a presynaptic disorder similar to what is seen in myasthenic syndromes. Ultrastructural study of an intercostal muscle biopsy specimen obtained 17 days after the onset of weakness . . . [Full Text PDF of this Article]

Footnotes
Edited by Drummond Rennie, MD, Deputy Editor (West), and Bruce B. Dan, MD, Senior Editor.

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