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• W2041572016 abstract "Train-of-four (TOF) monitoring is recommended in published guidelines during use of continuous- infusion neuromuscular blocking agents (NMB) in the intensive care unit (ICU). To test that recommendation, dual protocols were established in a medical ICU after intensive nursing education. Paralyzed patients received either TOF monitoring with a goal of three twitches or best clinical assessment while receiving atracurium by continuous infusion. Demographics and mean duration of paralysis of 20 patients in the TOF group were no different than that of the 16 patients in the best clinical assessment group. Although most patients demonstrated atracurium tolerance over time, there was no difference between groups in total mg ( ± SEM) infused (10,460 ± 2,409 versus 9,201 ± 3,237) or mean μ g/kg/min (15.2 ± 1.5 versus 12.0 ± 1.1). The time to clinical recovery was no different between groups (50 ± 10 versus 45 ± 12 min). Two complications occurred in the TOF group, with pulmonary emboli despite prophylaxis and an unrecognized cerebrovascular accident in one patient each. We conclude that careful titration of NMB using clinical bedside markers should remain the standard of care with these drugs." @default.
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• W2041572016 date "1997-11-01" @default.
• W2041572016 modified "2023-09-27" @default.
• W2041572016 title "Comparison of Train-of-Four and Best Clinical Assessment during Continuous Paralysis" @default.
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• W2041572016 doi "https://doi.org/10.1164/ajrccm.156.5.9701079" @default.
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