medigraphic.com
ISSN 2448-8909 (Print)

2000, Number 6

<< Back

Med Crit 2000; 14 (6)

Residual effect of neuromuscular blockade in the critically ill patient

Maycotte LZ, Martínez SJ, Franco GJ, Elizalde GJJ, Sánchez VLD

Language: Spanish
References: 14
Page: 215-219
PDF size: 127.27 Kb.


ABSTRACT

Objective: Monitoring neuromuscular blockade in ICU patients.
Design: Case series report.
Setting: ICU of a private medical center, Mexico City.
Patients: Twenty-two patients assisted with mechanical ventilation.
Interventions: Before extubation the degree of neuromuscular blockade was evaluated using the method of train of four (TOF).
Measurements and main results: The patients were assisted with mechanical ventilation during 74.6 ± 96.6 hours (range 10-370 hours) and an stimulation of 26.5 ± 11.1 mA was required. No patient was reintubated.
Conclusion: The monitoring of neuromuscular blockade through TOF may useful to predict a successfully extubation.


REFERENCES

  1. Shapiro BA, Warren J. Practice parameters for intravenous analgesia and sedation for adult patient in the intensive care unit: An executive summary. Crit Care Med 1995; 23: 1601-1605.

  2. Tof-Guard, Operating Manual. Organon Teknika NV, 2300 Turnhout, Belgium.

  3. Topulos G. Neuromuscular blockade in adult intensive care. New Hor 1993; 1: 447-462.

  4. Gouch J. Prolongade paralisis after treatment with neuromuscular junction blocking agents. Crit Care Med 1991; 19: 1125-1131.

  5. Hansen-Flashen J. Use of sedating drugs and neuromuscular blocking agents in patients requiring mechanical ventilation for respiratory failure. JAMA 1991; 266: 2870-2875.

  6. Watling SM. Prolonged paralysis in intensive care unit patients after the use of neuromuscular blocking agents: A review of the literature. Crit Care Med 1994; 22: 884-893.

  7. Wheeler AP. Sedation, analgesia, and paralysis in the intensive care unit. Chest 1993; 104: 566-577.

  8. Griffin D, Fairman N. Acute myopathy after treatment of status asthmaticus with corticosteroids and steroidal muscle relaxants. Chest 1992; 102: 510-514.

  9. Viby MJ. Neuromuscular monitoring. In: Miller R. Ed. Anesthesia. New York, Churchill Livingtone. 1990: 1209-1226.

  10. Ford VE. Monitoring neuromuscular blockade in the adult UCI. Am J Crit Care 1995; 4: 122-130.

  11. Society of critical care. Medicine, Multidisciplinary Critical Care Board Review Course, 1997: Chicago II.

  12. Dulin PG. Monitoring and preventive care of the paralyzed patient in respiratory failure. Crit Care Clin 1994; 10:815-829.

  13. Frankel H, Jeng J. The impact of implementation of neurmuscular blockade monitoring standards in surgical intensive care unit. Crit Care Med 1994; 22: A94.

  14. Harper NJ. Neuromuscular blocking drugs: Practical aspects of research in the intensive care unit. Intensive Care Med 1993; 19(Suppl): 2S80-2S85.




2020     |     www.medigraphic.com