title: Functional recovery after neuromuscular blockade in mechanically ventilated critically ill patients.
abstract: BACKGROUND
  An estimated 24% to 70% of individuals have prolonged paralysis or severe weakness after receiving neuromuscular blocking agents (NMBAs) when therapy is terminated.
  
  
  OBJECTIVE
  The purposes of this study were to (1) evaluate the relationship between recovery of neuromuscular transmission (NMT) and functional muscle activity after NMBA administration; (2) evaluate the relationship between delayed recovery of NMT or muscle activity and functional performance; and (3) determine the predictors of delayed recovery of NMT, muscle activity, and functional performance.
  
  
  METHODS
  This was a multisite study using a prospective, nonexperimental, descriptive design with convenience sampling techniques. Instruments used included a five-point muscle score, Actigraph, and peripheral nerve stimulator.
  
  
  RESULTS
  Key findings were as follows: (1) NMT returned promptly, whereas muscle activity remained severely depressed; (2) only two subjects (5%) recovered functional performance within 24 hours; (3) degree of muscle weakness immediately after neuromuscular blockade was associated with prolonged time to extubation and mobility; and (4) predictors of delayed recovery included cumulative dose of aminosteroid NMBAs, age, and renal function.
  
  
  CONCLUSIONS
  Prolonged recovery of muscle activity and extreme weakness may occur despite brisk recovery of NMT after neuromuscular blockade.
authors.affiliation: Texas Woman's University, Houston, Texas 77030, USA.
authors.forename: Janet G
authors.initials: JG
authors.lastname: Whetstone Foster
authors.forename: Angela P
authors.initials: AP
authors.lastname: Clark
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004357:Drug Synergism; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D018908:Muscle Weakness / Q000139:chemically induced* / Q000517:prevention & control; D019148:Neuromuscular Blockade / Q000009:adverse effects*; D009466:Neuromuscular Blocking Agents / Q000009:adverse effects* / Q000493:pharmacokinetics; D020511:Neuromuscular Junction Diseases / Q000139:chemically induced* / Q000517:prevention & control; D011446:Prospective Studies; D020127:Recovery of Function; D012121:Respiration, Artificial
chemical_list: D009466:Neuromuscular Blocking Agents