The use of muscle relaxants in the intensive care unit.
Neuromuscular blocking agents are frequently used in the Intensive Care Unit to facilitate tracheal intubation and the application of continuous paralysis. This review will focus on various conditions of the critically ill patient such as multi-organ dysfunction, acid-base and electrolyte imbalance, prolonged immobility, multiple drug interactions and specific disease/injury processes that may affect the pharmacokinetic and pharmacodynamic behaviour of muscle relaxants. As such, due to the complex nature of the critically ill patients, the effects of neuromuscular blocking agents are unpredictable. Therefore, guidelines regarding their administration and the methodology and requirement for continuous bedside monitoring of neuromuscular function will be presented.
Sharpe
M D
MD
W.E. Spoerel Intensive Care Unit, University Hospital, Department of Anaesthesia, University of Western Ontario, London.
D006801:Humans; D007362:Intensive Care Units; D008991:Monitoring, Physiologic; D009466:Neuromuscular Blocking Agents / Q000009:adverse effects / Q000378:metabolism / Q000627:therapeutic use*; D009467:Neuromuscular Depolarizing Agents / Q000627:therapeutic use; D003473:Neuromuscular Nondepolarizing Agents / Q000627:therapeutic use
D009466:Neuromuscular Blocking Agents; D009467:Neuromuscular Depolarizing Agents; D003473:Neuromuscular Nondepolarizing Agents