Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Experiment Videos

Neuromuscular blockade in the intensive care unit.

L C Gehr1, C N Sessler

  • 1Department of Anesthesiology, Medical College of Virginia Hospital, Virginia Commonwealth University, Richmond, Virginia, USA. lcgehr@hsc.vcu.edu

Seminars in Respiratory and Critical Care Medicine
|August 10, 2005
PubMed
Summary

Neuromuscular blocking agents (NMBAs) are crucial for ICU mechanical ventilation but lack ideal properties. Careful patient selection and monitoring are essential to minimize NMBA complications like prolonged paralysis and myopathy.

Related Concept Videos

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

Comfort and distress in the ICU: scope of the problem.

Seminars in respiratory and critical care medicine·2005
Same author

Multidisciplinary management of sedation and analgesia in critical care.

Seminars in respiratory and critical care medicine·2005
Same author

Top ten list in sepsis.

Chest·2001
Same author

Alcohol-based handwashing agent improves hand washing.

Infection control and hospital epidemiology·2000
Same author

Continuous measurement of backrest elevation in critical care: a research strategy.

Critical care medicine·2000
Same author

Handwashing compliance by health care workers: The impact of introducing an accessible, alcohol-based hand antiseptic.

Archives of internal medicine·2000

Area of Science:

  • Critical Care Medicine
  • Pharmacology
  • Anesthesiology

Background:

  • Neuromuscular blocking agents (NMBAs) are indispensable in intensive care units (ICUs), primarily to facilitate mechanical ventilation.
  • The ideal NMBA would possess specific characteristics, including nondepolarization, no accumulation, easy titration, rapid onset/offset, independence from organ function for metabolism, and absence of toxic metabolites.

Purpose of the Study:

  • To review the current landscape of NMBAs used in critical care.
  • To highlight the limitations of existing agents and the importance of individualized patient selection.
  • To emphasize the necessity of a comprehensive management plan and monitoring for NMBA use.

Main Methods:

  • Review of current literature on neuromuscular blocking agents in the ICU setting.

Related Experiment Videos

  • Classification of existing NMBAs into aminosteroids and benzylisoquinoliniums.
  • Discussion of clinical application, patient selection criteria, and monitoring techniques.

    • Main Results:

    • Current NMBAs, categorized as aminosteroids or benzylisoquinoliniums, exhibit varying features but none meet all ideal criteria.
    • Individual patient characteristics dictate the optimal NMBA choice.
    • Effective management requires a holistic approach, including monitoring neuromuscular blockade via peripheral nerve stimulation.

    Conclusions:

    • While essential for critical illness management, NMBAs carry risks such as prolonged drug effect and acute quadriplegic myopathy, potentially leading to extended rehabilitation.
    • Cautious and structured utilization of NMBAs is urged to mitigate complications and ensure successful patient outcomes.