SummaryOver a period of one year, a weekly telephone survey identified 161 stable patients with weaning delay (defined as patients ventilated for at least 6 h per day for more than 2 weeks) in intensive care units in the Northern Region of England. Their median age was 69 years (range 21-88 years). Sixty patients (37%) were admitted with medical conditions, 89 (55%) were postoperative patients, whereas 12 (8%) were surgical but required non-operative admission. One hundred and thirty (89%) were weaned and discharged from the intensive care unit during the year. Twenty-two (14%) died and two were transferred to the home ventilation service. Seven patients remained ventilated in intensive care at the end of the study period. Twenty patients (12%) required more than 28 days of respiratory support. These patients occupied on average 6.0% of available intensive care unit beds in the region. This study suggests that in the Northern Region of England there are a significant number of stable but ventilator-dependent patients occupying intensive care beds.

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Critical hemoglobin desaturation will occur before return to an unparalyzed state following 1 mg/kg intravenous succinyl choline. Anesthesiology 1997; 87: 979-82. 4 Thwaites AJ, Rice CP, Smith I. Rapid sequence induction: a questionnaire survey of its routine conduct and continued management during a failed intubation. Anaesthesia 1999; 54: 376-81. 5 McCourt KC, Salmela L, Mirakhur RK, et al. Comparison of rocuronium and suxamethonium for use during rapid sequence induction of anaesthesia. Anaesthesia 1998; 53: 867-71. 6 Andrews JL, Kumar N, van den Brom RHG, Olkkola KT, Roest GJ, Wright PMC. A large simple randomized trial of rocuronium versus succinyl choline in rapidsequence induction of anaesthesia along with propofol. Acta Anaesthesiologica Scandinavica 1999; 43: 4-8. A reply Our objection to rocuronium for rapid sequence induction (RSI) is its prolonged duration of paralysis. The papers quoted by Dr Levy have shown that rocuronium provides intubating conditions similar to suxamethonium 1.0 mg.kg À1. The doses compared were 0.6 or 1.0 mg.kg À1 rocuronium and suxamethonium 1.0 mg.kg À1 [1, 2]. The relatively rapid recovery of