The adult respiratory distress syndrome and pancuronium bromide

The institution and maintenance of artificial ventilation for a patient with the adult respiratory distress syndrome (ARDS) is frequently difficult because the hypoxic patient is often confused, agitated, or combative. Pancuronium bromide, a recently introduced neuromuscular blocking agent, was used to facilitate artificial ventilation in 6 patients with ARDS. As compared with morphine sulfate and diazepam, pancuronium bromide has fewer cardiovascular and central-nervous system effects. It also has fewer cardiovascular effects than does curare, and its prolonged administration does not lead to a desensitization neuromuscular block as is seen with succinylcholine. However, continuous high-quality nursing care is necessary if this drug is used.