title: Train-of-four: to use or not to use.
abstract: A pattern of nerve stimulation called train-of-four (TOF) is frequently used to monitor therapy with nondepolarizing neuromuscular blocking agents in patients treated in intensive care units. Based on our experience with TOF monitoring in several critically ill patients, we believe its application as an indicator of neuromuscular blockade may be problematic in this setting.
mesh_terms: D016638:Critical Illness; D016903:Drug Monitoring / Q000379:methods; D004558:Electric Stimulation; D006801:Humans; D007362:Intensive Care Units; D009467:Neuromuscular Depolarizing Agents / Q000494:pharmacology*; D009469:Neuromuscular Junction / Q000187:drug effects*; D003473:Neuromuscular Nondepolarizing Agents / Q000494:pharmacology; D010525:Peripheral Nerves / Q000187:drug effects / Q000502:physiology*
chemical_list: D009467:Neuromuscular Depolarizing Agents; D003473:Neuromuscular Nondepolarizing Agents