title: The effect of induced hypothermia on the duration of action of atracurium when given by infusion to critically ill children.
abstract: The aim of the study was to investigate the effect of induced hypothermia on the offset time of atracurium when given by continuous infusion to critically ill children. Over a period of 8 months, six mechanically ventilated children had a steady-state infusion of atracurium discontinued. The offset time of atracurium was assessed by train-of-four (TOF) stimulation of the ulnar nerve; recording the time taken to reach a TOF ratio of 0.9. Nine assessments were carried out. The mean offset time of atracurium was 82 min. This was significantly longer than in patients with temperatures within the normal physiological range. When considering all assessments, performed both in hypothermic and normothermic patients, there is a strong correlation between rectal temperature and the offset time of atracurium. Prolonged moderate hypothermia has a very significant effect on the offset time of atracurium when given by infusion to critically ill children.
authors.affiliation: Paediatric Intensive Care Unit, Queens Medical Centre, Nottingham, UK.
authors.forename: S D
authors.initials: SD
authors.lastname: Playfor
authors.forename: D A
authors.initials: DA
authors.lastname: Thomas
authors.forename: I
authors.initials: I
authors.lastname: Choonara
mesh_terms: D000293:Adolescent; D001279:Atracurium / Q000493:pharmacokinetics*; D002648:Child; D002675:Child, Preschool; D003422:Critical Care; D016638:Critical Illness; D005260:Female; D006801:Humans; D007036:Hypothermia, Induced; D007223:Infant; D007262:Infusions, Intravenous; D008297:Male; D003473:Neuromuscular Nondepolarizing Agents / Q000493:pharmacokinetics*
chemical_list: D003473:Neuromuscular Nondepolarizing Agents; D001279:Atracurium