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Titolo:
Neuromuscular blockade in the intensive care unit
Autore:
Gehr, LC; Sessler, CN;
Indirizzi:
Virginia Commonwealth Univ, Virginia Hosp, Coll Med, Dept Anesthesiol, Richmond, VA USA Virginia Commonwealth Univ Richmond VA USA Anesthesiol, Richmond, VA USA Virginia Commonwealth Univ, Virginia Hosp, Coll Med, Div Pulm & Crit Care Med, Richmond, VA USA Virginia Commonwealth Univ Richmond VA USA it Care Med, Richmond, VA USA
Titolo Testata:
SEMINARS IN RESPIRATORY AND CRITICAL CARE MEDICINE
fascicolo: 2, volume: 22, anno: 2001,
pagine: 175 - 188
SICI:
1069-3424(2001)22:2<175:NBITIC>2.0.ZU;2-A
Fonte:
ISI
Lingua:
ENG
Soggetto:
CRITICALLY-ILL PATIENTS; PERIPHERAL-NERVE STIMULATION; BLOCKING-AGENTS; PROLONGED PARALYSIS; MECHANICAL VENTILATION; PANCURONIUM-BROMIDE; ACUTE MYOPATHY; SEVERE ASTHMA; INFUSION REQUIREMENTS; CLINICAL-ASSESSMENT;
Keywords:
neuromuscular blocking agent; peripheral nerve stimulation; prolonged paralysis;
Tipo documento:
Review
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
89
Recensione:
Indirizzi per estratti:
Indirizzo: Gehr, LC Virginia Commonwealth Univ, Dept Anesthesiol, 410 N 12th St, Richmond, VA 23298 USA Virginia Commonwealth Univ 410 N 12th St Richmond VA USA23298 SA
Citazione:
L.C. Gehr e C.N. Sessler, "Neuromuscular blockade in the intensive care unit", SEM RESP CR, 22(2), 2001, pp. 175-188

Abstract

Neuromuscular blocking agents (NMBA) are frequently utilized in the ICU, primarily to facilitate mechanical ventilation. An ideal NMBA is nondepolarizing, has no propensity to accumulate, is easily titrated, has a rapid onset and offset, does not rely on organ function for metabolism, and has no toxic or active metabolites. Current NMBAs are classified as aminosteroids orbenzylisoquinoliniums and have different features, bur none are ideal. Selection of the best NMBA is determined by individual patient characteristics. Proper use of these agents includes a comprehensive plan to manage all aspects oi care affected by NMBA, as well as monitoring of clinical effect and degree of neuromuscular blockade via periodic peripheral nerve stimulation. There are well-recognized complications of NMBA, including prolonged drug effect and acute quadriplegic myopathy. The latter condition can result in prolonged rehabilitation. The use of an NMBA can be essential for the successful outcome from critical illness; however, cautious use of these agents with a structured approach to minimize complications is urged.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 25/01/20 alle ore 19:39:57