Postal survey on the long-term use of neuromuscular block in the intensive care.
Joint meeting of the Intensive Care Society and Société de Réanimation de Langue Française. Brighton GBR, 1995/05.
To assess the long-term use of neuromuscular blocking (NMB) agents in intensive care, expecially with reference to the potential problems of the long-term use of NMB drugs in the intensive care unit (ICU).
A postal survey questionnaire was sent to 409 ICUs in Great Britain.
Two hundred thirty-eight completed questionnaires were returned and analysed.
Most ICUs were anaesthetist-led (85.8%) with only five ICUs being staffed by full-time intensivists.
Facilitation of mechanical ventilation and increased intracranial pressure were the main indications for the prolonged use of neuromuscular blockade.
Atracurium and vecuronium (83%) were administered most commonly by bolus alone (13.8%), bolus followed by continuous infusion (23.9%) or continuous infusion only (60.9%). The most frequently cited criteria for the use of either vecuronium or stracurium were their pharmacokinetics and haemodynamic stability.
Neuromuscular block was most commonly monitored clinically (91.7%), with only 8.3% of the responders using a peripheral nerve stimulator.
All responders indicated the concomitant use of sedatives (propofol/midazolam alone or in combination in 89.4% of responders) and/or opioids (morphine, fentanyl or alfentanil in 74.8% of respondents) with muscle relaxants.
Most responders agreed that while neuromuscular block in the ICU population may provide advantages, it cannot be considered benign. (...)
Mots-clés Pascal : Curarisation, Curarisant, Unité soin intensif, Pratique professionnelle, Anesthésiste, Questionnaire, Evaluation, Homme, Grande Bretagne, Royaume Uni, Europe, Long terme, Anesthésie, Soin intensif, Médecin
Mots-clés Pascal anglais : Neuromuscular blocking, Neuromuscular blocking agent, Intensive care unit, Professional practice, Anesthesiologist, Questionnaire, Evaluation, Human, Great Britain, United Kingdom, Europe, Long term, Anesthesia, Intensive care, Physician
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 96-0471064
Code Inist : 002B02B08. Création : 10/04/1997.