Atracurium infusion in the intensive care unit

Area of Science:

• Anesthesiology
• Pharmacology
• Critical Care Medicine

Background:

• Neuromuscular blockade is essential for mechanical ventilation in critically ill patients.
• Atracurium is a commonly used non-depolarizing neuromuscular blocking agent.
• Understanding the safety and efficacy of long-term infusions is crucial.

Purpose of the Study:

• To evaluate the efficacy and safety of continuous atracurium infusions for neuromuscular blockade in ventilated patients.
• To determine the average infusion rate and recovery time associated with atracurium.
• To assess for any serious toxic effects during long-term atracurium administration.

Main Methods:

• An open study involving 33 patients requiring mechanical ventilation.
• Atracurium infusions were initiated at 0.4 mg kg-1 h-1 and adjusted based on clinical assessment and neuromuscular stimulation.
• Patients received concurrent sedation with morphine infusions.

Main Results:

• Satisfactory neuromuscular blockade was achieved in all 38 infusions.
• The average atracurium infusion rate was 0.59 mg kg-1 h-1.
• Average recovery time after infusion cessation was 39.2 minutes.

Conclusions:

• Continuous atracurium infusion is an effective method for maintaining neuromuscular blockade in ventilated patients.
• No serious toxic effects were observed during long-term atracurium infusions.
• Atracurium offers a predictable recovery profile following prolonged administration.