ABSTRACT
BACKGROUND: This study was done to determine the safety, efficacy, dosing requirements, and spontaneous recovery profiles of prolonged infusions of rocuronium bromide in the critically ill. METHODS: This multicenter, prospective, nonrandomized, open label trial enrolled 32 patients at two university-based medical centers. Patients who were determined to require neuromuscular blockade for at least 24 hours received a bolus of 0.6 mg/kg of rocuronium. After subsequent recovery of two responses (T2) to the TOF stimulation, an infusion of rocuronium was begun at 10 microg/kg/min and continued for 24 to 120 hours as required by the patients' clinical status. RESULTS: Patients were divided into multiple organ failure (MOF) and non-multiple organ failure (non-MOF) groups on enrollment. The mean infusion rates for the MOF and non-MOF groups were 0.2 and 0.5 mg/kg/hour, respectively. CONCLUSION: The mean infusion rate of rocuronium that provides approximately 90% blockade is less for critically ill patients with MOF. Spontaneous recovery was prolonged in patients with MOF.
Subject(s)
Androstanols/administration & dosage , Multiple Organ Failure/therapy , Neuromuscular Nondepolarizing Agents/administration & dosage , Respiration, Artificial , Adult , Androstanols/pharmacokinetics , Critical Illness , Drug Monitoring , Female , Humans , Infusions, Intravenous , Injections, Intravenous , Male , Metabolic Clearance Rate , Middle Aged , Multiple Organ Failure/etiology , Multiple Organ Failure/metabolism , Multiple Organ Failure/mortality , Neuromuscular Nondepolarizing Agents/pharmacokinetics , Prospective Studies , Rocuronium , Time FactorsSubject(s)
Enteral Nutrition , Esophagus , Gastrostomy , Intubation/adverse effects , Pneumoperitoneum/etiology , Aged , Female , Gastroscopy , Humans , Intubation, IntratrachealABSTRACT
Necrotizing tracheobronchitis (NT) associated with conventional mechanical ventilation or high-frequency jet ventilation (HFJV) is a lesion reported most often in neonates. In most cases, a specific cause is not identified. We describe a case of NT in an adult that occurred during HFJV and was attributable to inadequate humidification.
