Abstract
Neuromuscular blocking agents are frequently used in the Intensive Care Unit to facilitate tracheal intubation and the application of continuous paralysis. This review will focus on various conditions of the critically ill patient such as multi- organ dysfunction, acid- base and electrolyte imbalance, prolonged immobility, multiple drug interactions and specific disease/injury processes that may affect the pharmacokinetic and pharmacodynamic behaviour of muscle relaxants. As such, due to the complex nature of the critically ill patient, the effects of neuromuscular blocking agents are unpredictable. Therefore, guidelines regarding their administration and the methodology and requirement for continuous bedside monitoring of neuromuscular function will be presented.
Résumé
En réanimation, on utilise souvent les myorelaxants pour faciliter iintubation endotrachéale et maintenir un niveau de paralysie constant. Ce travail passe en revue les conditions propres au grand malade comme les défalliances polyviscérales, les dérangements acido-basiques et électrolytiques, l’immobilisation de longue durée, les interactions médicamenteuses et les effets de différentes pathologies en cause sur le comportement pharmacocynétique et pharmacodynamique des myorelaxants. Ainsi par la complexité des difficultés rencontrées, leurs effets chez le malade dont l’état est critique sont difficiles a predire. Une ligne de conduite gouvernant leur administration et le monitorage continu qu ’elle nécessite sont présentés.
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Sharpe, M.D. The use of muscle relaxants in the intensive care unit. Can J Anaesth 39, 949–962 (1992). https://doi.org/10.1007/BF03008345
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DOI: https://doi.org/10.1007/BF03008345