What is the project?
TRIC-BLOCK is a nationwide service evaluation examining the use of continuous neuromuscular blockade in adult and paediatric Intensive Care Units across the UK. The project will assess how these infusions are prescribed, maintained, monitored, and discontinued in critically ill patients, as well as the frequency of their use and the patient groups in which they are used.
Led by Dr Richard O’Sullivan (North West ICM and Acute Medicine trainee), TRIC-BLOCK is delivered by the TRIC Network in partnership with the Paediatric Critical Care Society Trainee’s Audit & Research network (PICSTAR), and is supported by the Intensive Care Society and the Faculty of Intensive Care Medicine.
This is the first comprehensive evaluation of its kind in the UK. We want to include as many ICUs as possible to get an accurate representation of UK practice!
Why is the project important?
Continuous NMBD infusions are commonly used in UK ICUs for conditions such as severe acute respiratory distress syndrome (ARDS), traumatic brain injury, and ventilator dyssynchrony. Despite their widespread use, there is uncertainty and variation in practice regarding drug selection, dosing, monitoring, and discontinuation, with limited evidence to guide clinicians.
Prolonged use of NMBDs may lead to complications such as ICU-acquired weakness and increased mortality, especially in patients with organ dysfunction.
By evaluating current practice, TRIC-BLOCK will provide a clear baseline to inform future research and guideline development.
What are the aims of the project?
1. To evaluate current UK ICU practice in prescribing, maintaining, monitoring, and discontinuing NMBD infusions in critically ill adults and children.
2. To capture national variation in practice and assess prevalence, indications, dosing regimens, monitoring strategies, and adverse events associated with continuous NMBD use.
What is the likely time commitment?
The evaluation involves a 14-day screening window, which can begin at any time between 2nd and 22nd March 2026. All patients newly started on invasive mechanical ventilation during this period will be included. Each patient will be followed for 7 days, with full data collection required *only* for those receiving continuous NMBD infusions.
The time commitment is expected to be similar to previous TRIC projects.
What are the benefits of contributing?
This is an excellent opportunity to contribute to a national, trainee-led service evaluation. All collaborators will be acknowledged in any resulting publications. Participation can also be used as evidence of audit involvement for portfolio requirements or job applications.
What can I do to participate?
If you would like to express your interest in becoming a site lead for your ICU please complete this form: https://forms.gle/AQZcSp8qfLnURTma9
Any questions: tricblock@gmail.com