HEMODYNAMIC &amp; OXYGEN TRANSPORT EFFECTS OF PANCURONIUM IN CRITICALLY ILL PATIENTS

Beards, S. C.; Shelly, Michal; Lipman, Jonathan J.

doi:10.1097/00003246-199401000-00444

Cited by 1 publication

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“…In addition, the cardiovascular effects of pancuronium may also have led to difficulties in the interpretation of the haemodynamic data: pancuronium is an indirect sympathomimetic and pro-duces pulmonary hypertension, which decreases hypoxic pulmonary vasoconstriction and may lead to increased venous admixture. In contrast, a study by Beards et al 14 found no change in oxygen delivery or consumption after a single bolus of pancuronium. Unfortunately no sedation scores were measured and the degree of neuromuscular blockade was not recorded.…”

Section: Discussionmentioning

confidence: 84%

The Effect of Neuromuscular Blockade on Oxygen Supply, Consumption, and Total Chest Compliance in Patients with High Oxygen Requirements Undergoing Mechanical Ventilation

Russell

Greer

Harper

2002

Anaesth Intensive Care

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We investigated the effects of neuromuscular blockade with atracurium on oxygen consumption, oxygen delivery and total chest compliance in 20 sedated intensive care patients who required mechanical ventilation with an inspired oxygen fraction of at least 0.6.The reverse Fick method was used to measure oxygen consumption. Total chest compliance was measured from the ventilator pneumotachograph and pressure transducer. Measurements were made before neuromuscular blockade, at a standard level of neuromuscular blockade, and after demonstrated recovery of neuromuscular function.There was no statistical difference in any of the parameters measured. However there were large changes in oxygen consumption (range -35% to +17%) and total chest compliance (range -19.7% to + 9.7%) in individuals.We conclude that in the setting of critical oxygenation, neuromuscular blockade cannot be assumed to reduce oxygen requirements or improve total lung compliance. If, however, neuromuscular blockade is selected as an adjunct to therapy, we recommend that the indices of oxygenation are calculated.

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Section: Discussionmentioning

confidence: 84%