Adjusting the dosage of vecuronium by peripheral nerve stimulation versus standard clinical dosing in critically ill patients reduces drug requirements to maintain a desired depth of paralysis and, on average, produces faster recovery of neuromuscular function.
We retrospectively analyzed the health and economic outcomes of using train-of-four (TOF) end points by peripheral nerve stimulation in dosing neuromuscular blocking agents during continuous infusion in a medical intensive care unit (ICU).
A decision-analytic model was used to calculate outcomes and costs of treatment using and not using TOF end points of dosing vecuronium.
Data from our TOF trial provided the difference in neuromuscular and functional recovery time.
Charges billed by the Patient Financial Services Department were used to determine hourly costs of ICU stay for recovery from neuromuscular blockade using costs : charges ratios estimated from a sample of 20 patients.
The cost of vecuronium was determined using the hospital acquisition cost and the actual number of milligrams of drug given to each patient in the TOF trial.
The cost of performing one TOF event was determined by timing six events performed by six pharmacists, and randomly selecting 60% of these to calculate a mean time/TOF event.
The economic impact of dosing by TOF was determined by calculating the cost savings/patient dosed by TOF compared with those who had doses individualized by standard clinical assessment. (...)
Mots-clés Pascal : Bromure de vécuronium, Analyse coût efficacité, Coût global, Dose, Rétrospective, Economie santé, Méthode biologique, Analyse quantitative, Modèle, Curarisant non dépolarisant, Nerf périphérique, Conduction nerveuse, Stimulation, Etude comparative, Perfusion, Continu, Homme, Unité soin intensif, Ajustement posologie
Mots-clés Pascal anglais : Vecuronium bromide, Cost efficiency analysis, Life cycle cost, Dose, Retrospective, Health economy, Biological method, Quantitative analysis, Models, Non depolarisant myorelaxant, Peripheral nerve, Nerve conduction, Stimulation, Comparative study, Perfusion, Continuous, Human, Intensive care unit, Dosage adjustment
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0269267
Code Inist : 002B02C. Création : 15/07/1997.