Multicenter trial of prolonged infusions of rocuronium bromide in critically ill patients: effects of multiple organ failure.
BACKGROUND
This study was done to determine the safety, efficacy, dosing requirements, and spontaneous recovery profiles of prolonged infusions of rocuronium bromide in the critically ill.


METHODS
This multicenter, prospective, nonrandomized, open label trial enrolled 32 patients at two university-based medical centers. Patients who were determined to require neuromuscular blockade for at least 24 hours received a bolus of 0.6 mg/kg of rocuronium. After subsequent recovery of two responses (T2) to the TOF stimulation, an infusion of rocuronium was begun at 10 microg/kg/min and continued for 24 to 120 hours as required by the patients' clinical status.


RESULTS
Patients were divided into multiple organ failure (MOF) and non-multiple organ failure (non-MOF) groups on enrollment. The mean infusion rates for the MOF and non-MOF groups were 0.2 and 0.5 mg/kg/hour, respectively.


CONCLUSIONS
The mean infusion rate of rocuronium that provides approximately 90% blockade is less for critically ill patients with MOF. Spontaneous recovery was prolonged in patients with MOF.
Circeo
L E
LE
Department of Anesthesia, Baystate Medical Center, Tufts University School of Medicine, Springfield, Mass 01199, USA.
Reeves
S T
ST
D000328:Adult; D000732:Androstanols / Q000008:administration & dosage* / Q000493:pharmacokinetics; D016638:Critical Illness; D016903:Drug Monitoring; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D007275:Injections, Intravenous; D008297:Male; D008657:Metabolic Clearance Rate; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000209:etiology / Q000378:metabolism / Q000401:mortality / Q000628:therapy*; D003473:Neuromuscular Nondepolarizing Agents / Q000008:administration & dosage* / Q000493:pharmacokinetics; D011446:Prospective Studies; D012121:Respiration, Artificial; D000077123:Rocuronium; D013997:Time Factors
D000732:Androstanols; D003473:Neuromuscular Nondepolarizing Agents; D000077123:Rocuronium