title: [Contraindications to succinylcholine in the intensive care unit. A prevalence study].
abstract: OBJECTIVE
  To determine the prevalence of contraindications to succinylcholine in patients admitted to the ICU.
  
  
  METHODS
  An observational study was carried out, describing the frequency of succinylcholine contraindication by stays, and associating the contraindications to population variables.
  
  
  METHODS
  The adult general ICU of a reference hospital.
  
  
  METHODS
  Clinical-surgical critically ill patients. Thirty consecutive days were analyzed.
  
  
  METHODS
  None.
  
  
  METHODS
  Population variables: age, sex, APACHE II and SOFA scores, illness, days of hospitalization, mechanical ventilation and renal replacement therapy.
  
  
  METHODS
  hyperkalemia, bedridden patients, rhabdomyolysis, muscle trauma, burns, infusion of neuromuscular blocking agents, acute renal failure, chronic renal failure, intraocular hypertension, intracranial hypertension, statin use, malignant hyperthermia, neuromuscular disease, spinal cord sectioning, bradycardia < 50 bpm, succinylcholine allergy, and pseudo-cholinesterase deficiency.
  
  
  RESULTS
  A total of 102 patients were admitted, aged 60 ± 16 years (56.9% males), with the generation of 657 stays. Main diseases: elective heart surgery (33%), respiratory failure (22%) and sepsis (14%). We documented 466 stays (70.9%) with contraindications, particularly bedridden patients (n=140), neuromuscular blocking agents (n=101), acute renal failure (n=126), statin use (n=167), neuromuscular disease (n=159) and bradycardia (n=76). We recorded 74 stays (11.3%) at high risk of complications, secondary to hyperkalemic risk associated to receptor dysregulation. A high risk of complications was associated to advanced age, prolonged hospitalization, prolonged length of stay in the ICU, higher APACHE II and SOFA scores, mechanical ventilation and renal replacement therapy.
  
  
  CONCLUSIONS
  Given the high prevalence of contraindications to succinylcholine observed, we discourage its use in patients admitted to the ICU.
authors.affiliation: Servicio de Medicina Intensiva, Hospital Universitario de Cruces, Baracaldo, Vizcaya, España. Electronic address: tomas.munozmartinez@osakidetza.net.
authors.forename: T
authors.initials: T
authors.lastname: Muñoz-Martínez
authors.affiliation: Servicio de Medicina Intensiva, Hospital Universitario de Cruces, Baracaldo, Vizcaya, España.
authors.forename: I
authors.initials: I
authors.lastname: Garrido-Santos
authors.affiliation: Servicio de Medicina Intensiva, Hospital Universitario de Cruces, Baracaldo, Vizcaya, España.
authors.forename: R
authors.initials: R
authors.lastname: Arévalo-Cerón
authors.affiliation: Servicio de Medicina Intensiva, Hospital Universitario de Cruces, Baracaldo, Vizcaya, España.
authors.forename: L
authors.initials: L
authors.lastname: Rojas-Viguera
authors.affiliation: Servicio de Medicina Intensiva, Hospital Universitario de Cruces, Baracaldo, Vizcaya, España.
authors.forename: T
authors.initials: T
authors.lastname: Cantera-Fernández
authors.affiliation: Servicio de Medicina Intensiva, Hospital Universitario de Cruces, Baracaldo, Vizcaya, España.
authors.forename: R
authors.initials: R
authors.lastname: Pérez-González
authors.affiliation: Servicio de Medicina Intensiva, Hospital Universitario de Cruces, Baracaldo, Vizcaya, España.
authors.forename: E
authors.initials: E
authors.lastname: Díaz-Garmendia
mesh_terms: D000075202:Contraindications; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D013390:Succinylcholine
chemical_list: D013390:Succinylcholine
keywords: Adverse event; Critically ill patient; Efecto adverso; Intensive Care Unit; Paciente crítico; Patient safety; Rapid sequence intubation; Secuencia rápida de intubación; Seguridad del paciente; Succinilcolina; Succinylcholine; Unidad de cuidados intensivos