A review of neuromuscular blockade in the critically ill patient.
The continuous administration of neuromuscular blocking agents is thought to be associated with a number of adverse effects and complications, including post-paralytic syndrome (characterized by persistent paralysis), muscle weakness, and the inability to wean from the ventilator despite discontinuation of the therapy. Consequently, clinical objectives emphasize administering only the dose necessary to optimize the effect of the drug and for the shortest possible time. This article provides an overview of the administration of neuromuscular blocking agents, from the perspective of a critical care pharmacist and critical care nurses. The complexities associated with pharmacological paralysis in critically ill patients warrants the comprehensive approach to care that multidisciplinary team members can provide.
Burry
L
L
Mount Sinai Hospital, Toronto, Ontario.
HoSang
M
M
Hynes-Gay
P
P
D003422:Critical Care / Q000379:methods*; D016638:Critical Illness; D006801:Humans; D008991:Monitoring, Physiologic; D019148:Neuromuscular Blockade / Q000379:methods*; D009466:Neuromuscular Blocking Agents / Q000494:pharmacology*; D009469:Neuromuscular Junction / Q000502:physiology
D009466:Neuromuscular Blocking Agents