Neuromuscular blocking agents in the management of respiratory failure

Indications and treatment guidelines

Adam Sapirstein, W. E. Hurford

Research output: Contribution to journalArticle

Abstract

Local custom continues to dictate the clinical use of NMBDs in critically ill patients with respiratory failure. The safety of long-term administration of NMBDs to critically ill patients remains of great concern. Studies that clearly delineate the cause of severe myopathies and neuropathies in critically ill paralyzed patients remain to be performed. Because it appears these disorders may be related to the administration of drugs with steroidal structure, we believe it is prudent to avoid such drugs, if possible, in critically ill patients. We therefore continue to use curare, a nonsteroidal drug with a long history of safety, for long-term paralysis in these patients. Similarly, we believe that it is prudent to monitor the efficacy of NMBDs via the routine use of ulnar nerve stimulation. Patient movement in the face of adequate neuromuscular blockade as assessed by ulnar nerve stimulation then can be treated by deepening the level of sedation rather than by continually increasing the dose of the NMBD.

Original languageEnglish (US)
Pages (from-to)831-843
Number of pages13
JournalCritical Care Clinics
Volume10
Issue number4
StatePublished - 1994
Externally publishedYes

Fingerprint

Neuromuscular Blocking Agents
Respiratory Insufficiency
Guidelines
Critical Illness
Ulnar Nerve
Therapeutics
Pharmaceutical Preparations
Curare
Safety
Neuromuscular Blockade
Muscular Diseases
Paralysis

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Neuromuscular blocking agents in the management of respiratory failure : Indications and treatment guidelines. / Sapirstein, Adam; Hurford, W. E.

In: Critical Care Clinics, Vol. 10, No. 4, 1994, p. 831-843.

Research output: Contribution to journalArticle

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