lunes, 7 de diciembre de 2015

Relajantes neuromusculares en UCI/Neuromuscular blocking agents in ICU

Diciembre 7 2015. No. 2168

Relajantes neuromusculares en pacientes con ARDS. Sumario de las evidencias actuales de tres estudios aleatorizados y controlados
Neuromuscular blocking agents in patients with acute respiratory distress syndrome: a summary of the current evidence from three randomized controlled trials.
Ann Intensive Care. 2012 Jul 26;2(1):33. doi: 10.1186/2110-5820-2-33.
CONCLUSIONS: The use of NMBA in the early phase of ARDS improves outcome.
Mejor evidencia en cuidados intensivos. Papel de los relajantes neuromusculares en la etapa temprana del síndrome de dificultad respiratoria aguda
Best evidence in critical care medicine: The role of neuromuscular blocking drugs in early severe acute respiratory distress syndrome.
Can J Anaesth. 2012 Jan;59(1):105-8. doi: 10.1007/s12630-011-9615-2. Epub 2011 Nov 1.
CONCLUSIONS: Treatment in early severe ARDS with the NMBA, cisatracurium, for 48 hr was associated with lower adjusted 90-day mortality. It was also associated with decreased morbidity, which included increased ventilator-free days, increased ICU-free days, and increased organ failure-free days. These benefits occurred without increasing the incidence of ICU-acquired weakness.
Sedación y parálisis
Sedation and paralysis.
Respir Care. 2013 Jun;58(6):1024-37. doi: 10.4187/respcare.02232.
Sedation is used almost universally in the care of critically ill patients, especially in those who require mechanical ventilatory support or other life-saving invasive procedures. This review will focus on the sedation strategies for critically ill patients and the pharmacology of commonly used sedative agents. The role of neuromuscular blocking agents in the ICU will be examined and the pharmacology of commonly used agents is reviewed. Finally a strategy for rational use of these sedative and neuromuscular blocking agents in critically ill patients will be proposed.
KEYWORDS: critical illness; mechanical ventilation; neuromuscular blocking agent; sedation; sedatives

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