Neuromuscular blocking agents for ARDS: firm evidences for ICU mortality but for long-term mortality

2021 ◽  
pp. respcare.08926
Author(s):  
Maria Vargas ◽  
Giuseppe Servillo
Keyword(s):  
Neuromuscular Blocking ◽  
Neuromuscular Blocking Agents ◽  
Icu Mortality ◽  
Blocking Agents ◽  
Long Term Mortality

A national survey of critical care nurses' practices related to administration of neuromuscular blocking agents

2001 ◽  
Vol 10 (3) ◽  
pp. 139-145 ◽  
Author(s):  
JG Foster ◽  
SK Kish ◽  
CH Keenan
Keyword(s):  
Critical Care ◽  
Peripheral Nerve ◽  
The United States ◽  
Neuromuscular Blocking ◽  
Neuromuscular Blocking Agents ◽  
Critical Care Nurses ◽  
Blocking Agents ◽  
Care Facilities ◽  
Acute Care Facilities

BACKGROUND: Recommendations on use of neuromuscular blocking agents include using peripheral nerve stimulators to monitor depth of blockade and concomitantly administering sedatives and/or analgesics. OBJECTIVE: To evaluate critical care nurses' practices in administering neuromuscular blocking agents. METHODS: A 16-item survey was mailed to 483 acute care facilities in the United States. Of these, 246 surveys (51%) were returned and analyzed to determine use of neuromuscular blocking agents, peripheral nerve stimulators, sedatives, and analgesics. Logistic regression analysis was used to find independent predictors of use of peripheral nerve stimulators. RESULTS: Seventy-five percent of respondents reported long-term use of neuromuscular blocking agents in critically ill patients. Of those, 63% monitored the level of blockade with peripheral nerve stimulators. Reasons for not using peripheral nerve stimulators included unavailability of equipment (48%), lack of training (36%), and insufficient evidence that peripheral nerve stimulators improve care (23%). Predictors of use of stimulators were facilities with more than 150 beds (P < .001) and administration of neuromuscular blocking agents by continuous infusion (P < .001). Ninety-five percent of respondents reported using concurrent analgesics/sedatives always or most of the time. Facilities with fewer than 10 beds in the intensive care unit used concurrent analgesics/sedatives significantly less often than did facilities with 10 beds or more (90% vs 98%, respectively; P = .03). CONCLUSIONS: Small and large facilities differ in concomitant use of analgesics/sedatives and peripheral nerve stimulators. Education and research are needed to ensure that patients receive adequate monitoring and sedation during administration of neuromuscular blocking agents.

Intermediate-Acting Nondepolarizing Neuromuscular Blocking Agents and Risk of Postoperative 30-Day Morbidity and Mortality, and Long-term Survival

2017 ◽  
Vol 124 (5) ◽  
pp. 1476-1483 ◽  
Author(s):  
Michael R. Bronsert ◽  
William G. Henderson ◽  
Terri G. Monk ◽  
Joshua S. Richman ◽  
Jennifer D. Nguyen ◽  
...  
Keyword(s):  
Neuromuscular Blocking ◽  
Neuromuscular Blocking Agents ◽  
Morbidity And Mortality ◽  
Term Survival ◽  
Long Term Survival ◽  
Blocking Agents

Prolonged paralysis after long-term infusion of neuromuscular blocking agents

1994 ◽  
Vol 20 (6) ◽  
pp. 461-462 ◽  
Author(s):  
K. Kuteifan ◽  
A. Baziz ◽  
F. Martin-Barbaz ◽  
J. Ferret ◽  
J-M. Descamps
Keyword(s):  
Neuromuscular Blocking ◽  
Neuromuscular Blocking Agents ◽  
Blocking Agents

scholarly journals Use of Sedatives and Neuromuscular-Blocking Agents in Mechanically Ventilated Patients with COVID-19 ARDS

2021 ◽  
Vol 9 (11) ◽  
pp. 2393
Author(s):  
Amédée Ego ◽  
Lorenzo Peluso ◽  
Julie Gorham ◽  
Alberto Diosdado ◽  
Giovanni Restuccia ◽  
...  
Keyword(s):  
Distress Syndrome ◽  
Neuromuscular Blocking ◽  
Neuromuscular Blocking Agents ◽  
Inclusion Criteria ◽  
Mechanically Ventilated ◽  
Blocking Agents ◽  
Observational Cohort ◽  
Sedative Drugs ◽  
Retrospective Observational Cohort Study

Objectives: To assess differences in the use of analgesics, sedatives and neuromuscular-blocking agents (NMBA) in patients with acute respiratory distress syndrome (ARDS) due to COVID-19 or other conditions. Methods: Retrospective observational cohort study, single-center tertiary Intensive Care Unit. COVID-19 patients with ARDS (March–May 2020) and non-COVID ARDS patients (2017–2020) on mechanical ventilation and receiving sedation for at least 48 h. Results: A total of 39 patients met the inclusion criteria in each group, with similar demographics at baseline. COVID-19 patients had a longer duration of MV (median 22 (IQRs 16–29) vs. 9 (6–18) days; p < 0.01), of sedatives administration (18 (11–22) vs. 5 (4–9) days; p < 0.01) and NMBA therapy (12 (9–16) vs. 3 (2–7) days; p < 0.01). During the first 7 days of sedation, compared to non-COVID patients, COVID patients received more frequently a combination of multiple sedative drugs (76.9% vs. 28.2%; p < 0.01) and a higher NMBA regimen (cisatracurium: 3.0 (2.1–3.7) vs. 1.3 (0.9–1.9) mg/kg/day; p < 0.01). Conclusions: The duration and consumption of sedatives and NMBA was significantly increased in patients with COVID-19 related ARDS than in non-COVID ARDS. Different sedation strategies and protocols might be needed in COVID-19 patients with ARDS, with potential implications on long-term complications and drugs availability.

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