Respiratory function in children during recovery from neuromuscular blockade.
Residual neuromuscular blockade is a major risk factor for respiratory insufficiency. We examined the relationship between neuromuscular and respiratory function in 18 ASA I or II children aged 2-4 years. Lung function was measured by pneumotachography and transpulmonary pressure, neuromuscular transmission by first twitch response ratio (T1:T1) and train-of-four ratio (TOFR), before and at specific points in recovery from vecuronium paralysis. The tidal volume was directly related to maximal inspiratory pressure at occlusion (PIOCC), P < 0.001, whereas the minute ventilation (VE) was related to the respiratory drive (P0.1), P < 0.001. The best predictors of minute ventilation were the P0.1 (r = 0.57), and the TOFR (r = 0.62). PIOCC and P0.1 correlated closely (r = 0.889, P = 0.002) but TOFR and T1:T1 did not correlate with either. Our results show that the occlusion pressure measurements, P0.1 and PIOCC, were good predictors of both VE.kg-1 and respiratory work.
Withington
D E
DE
Department of Anaesthesia, Montreal Children's Hospital, Québec, Canada.
Davis
G M
GM
Vallinis
P
P
Del Sonno
P
P
Bevan
J C
JC
D000762:Anesthesia Recovery Period; D002675:Child, Preschool; D006801:Humans; D019148:Neuromuscular Blockade; D009469:Neuromuscular Junction / Q000187:drug effects / Q000502:physiology; D015656:Respiratory Mechanics; D012132:Respiratory Muscles / Q000187:drug effects / Q000502:physiology; D009435:Synaptic Transmission / Q000187:drug effects