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• W2510132309 abstract "Purpose: Critically-ill patients who receive nondepolarizing neuromuscular blocking drugs (NMBDs) may be at risk of developing profound muscle weakness that may last for months after the NMBD is discontinued, especially when large cumulative doses of NMBDs and corticosteroids are co-administered to septic, mechanically ventilated patients. This review focuses on the etiology and clinical features of critical illness myopathy (CIM), summarizes specific risk factors for its development, and discusses strategies that might be used to attenuate or even prevent the development of this potentially devastating syndrome. Clinical features: The etiology of CIM is unknown. Whether it can develop in at-risk patients who undergo lengthy operations during which they receive NMBDs is also unknown. In some patients following exposure to NMBDs their motor systems are impaired secondary to loss of thick (myosin) filaments that render the muscle unexcitable to direct electrical stimulation, while the sensory system is spared. Management of patients who develop NMBD myopathy is supportive, consisting of nutritional support, physical therapy, and daily trials of decreased ventilatory support. Conclusion: Recent guidelines recommend that NMBDs be used in critically ill patients only when absolutely necessary, that the depth of muscle paralysis be monitored to avoid overdosing and metabolite accumulation, and that drug administration be curtailed periodically to allow interruption of sustained NMBD effect. Objectif : Les patients des soins intensifs risquent de subir une faiblesse musculaire profonde pendant des mois apres avoir eu des myorelaxants non depolarisants (MRND), surtout si de fortes doses cumulatives de MRND et des corticosteroides ont ete coadministres en presence de septicemie et de ventilation mecanique. Notre revue se concentre sur les causes et les elements cliniques de la myopathie de reanimation (MDR), resume les facteurs de risque specifiques de son developpement et discute des strategies qui pourraient attenuer ou meme prevenir l’evolution d’un syndrome possiblement devastateur." @default.
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• W2510132309 date "2006-01-01" @default.
• W2510132309 modified "2023-09-27" @default.
• W2510132309 title "Neuroanesthesia and Intensive Care Brief review: Nondepolarizing neuromuscular blocking drugs and critical illness myopathy (Revue sommaire : les myorelaxants non dépolarisants et la myopathie de réanimation)" @default.
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