Myopathy Following Mechanical Ventilation for Acute Severe Asthma

Behbehani, Nasser; Al-Mane, F; D’yachkova, Yulia; Paré, Peter D.; Fitzgerald, Joan

doi:10.1378/chest.115.6.1627

Cited by 146 publications

(67 citation statements)

References 17 publications

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“…[54] Non-invasive ventilation remains controversial and is not routinely recommended. [55] Criteria for endotracheal intubation/ICU admission are listed in Table 5, and suggested criteria for discharge from the emergency unit in Table 6.…”

Section: Mechanical Ventilationmentioning

confidence: 99%

Guideline for the management of acute asthma in adults: 2013 update

et al. 2012

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Section: Mechanical Ventilationmentioning

confidence: 99%

Guideline for the management of acute asthma in adults: 2013 update

et al. 2012

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“…42 NBDs have been defined as a risk factor for critical illness polyneuropathy and myopathy, conditions manifested by muscle weakness in critically ill patients. [11][12][13][14]42 Moreover, infusion of rocuronium 12 and cisatracurium 14 for a single day in rats compromises diaphragmatic function by a myopathic mechanism that does not involve neuromuscular transmission failure. 12 Moreover, the combination of 18 to 69 hours of complete diaphragmatic inactivity and mechanical ventilation results in marked atrophy of myofibers in the diaphragm of humans.…”

Section: Discussionmentioning

confidence: 99%

“…[8][9][10] Moreover, long-term administration of NBDs is a risk factor for the development of critical illness polyneuropathy. [11][12][13][14] Finally, recent animal data suggest that a constant neuromuscular blockade with rocuronium and cisatracurium over only a single day evokes a myopathy that significantly decreases diaphragmatic force. 12,14 Therefore, we feel it is important for clinicians to get information about variables that predict the duration of action of NBDs administered long-term.…”

mentioning

confidence: 99%

Clinical Predictors of Duration of Action of Cisatracurium and Rocuronium Administered Long-Term

Faßbender

Geldner

Blobner

et al. 2009

American Journal of Critical Care

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BackgroundThe duration of action of neuromuscular blocking drugs (NBDs) varies between individuals and even within individuals in different settings. Objectives To define predictors of variance in duration of action of rocuronium and cisatracurium administered long-term. Methods A prospective, double-blind, multicenter trial that included 113 patients scheduled for major abdominal surgery and postoperative admission to the intensive care unit. Patients received repetitive (median, 7) equipotent doses of rocuronium or cisatracurium to maintain deep relaxation (twitch height of the adductor pollicis muscle <25% of baseline). Effects of weight, age, sex, American Society of Anesthesiologists risk score, lowest core temperature, duration of NBD administration, and tobacco smoking history on duration of action of cisatracurium and rocuronium were determined via multiple regression analysis. Results Only duration of NBD administration was predictive of the duration of action of rocuronium. The predicted increase in time to recovery of the train-of-4 ratio to 0.9 (duration TOF 0.9) per hour of continuous NBD treatment was 12.4 minutes. In contrast, only lowest core body temperature was predictive of cisatracurium's duration of action, and the predicted in crease in duration TOF 0.9 per degree Celsius decrease was 9.8 min. Conclusion Duration of NBD treatment is strongly predictive of the duration of action of rocuronium, and body temperature is predictive of the duration of action of cisatracurium. These data may help decrease the incidence of drug-induced muscle weakness in recovery rooms and surgical intensive care units, particularly if neuromuscular transmission monitoring is not available.

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“…78 ICU-acquired weakness is a potential adverse event that may be associated with prolonged use of NMBAs, especially when corticosteroids are simultaneously administrated, or in patients with systemic inflammatory response or sepsis. [79][80][81][82][83] The prevalence of ICU-acquired weakness Fig. 1.…”

Section: Role Of Paralysis and Nmbas In The Icumentioning

confidence: 99%

Sedation and ParalysisDiscussion

et al. 2013

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Sedation is used almost universally in the care of critically ill patients, especially in those who require mechanical ventilatory support or other life-saving invasive procedures. This review will focus on the sedation strategies for critically ill patients and the pharmacology of commonly used sedative agents. The role of neuromuscular blocking agents in the ICU will be examined and the pharmacology of commonly used agents is reviewed. Finally a strategy for rational use of these sedative and neuromuscular blocking agents in critically ill patients will be proposed.

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Myopathy Following Mechanical Ventilation for Acute Severe Asthma

Cited by 146 publications

References 17 publications

Guideline for the management of acute asthma in adults: 2013 update

Guideline for the management of acute asthma in adults: 2013 update

Clinical Predictors of Duration of Action of Cisatracurium and Rocuronium Administered Long-Term

Sedation and ParalysisDiscussion

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