The effect of neuromuscular blockade on oxygen consumption in sedated and mechanically ventilated pediatric patients after cardiac surgery.

Abstract:

OBJECTIVE:To measure the effect of intense neuromuscular blockade (NMB) on oxygen consumption (VO(2)) in deeply sedated and mechanically ventilated children on the first day after complex congenital cardiac surgery. DESIGN:Prospective clinical interventional study. SETTING:Pediatric intensive care unit of an university medical centre. MEASUREMENTS AND RESULTS:Nine mechanically ventilated and sedated children (weight 2.8-8.7 kg) were included. All children were treated with vasoactive drugs. The level of sedation was quantified using the comfort score, Ramsay score and bispectral index (BIS). The intensity of NMB was quantified using acceleromyography and VO(2) was measured using indirect calorimetry. Analgo-sedation using various intravenous agents was targeted at a deep level (comfort score < 18, BIS < 60 and Ramsay score > 4). NMB was achieved by intravenous administration of rocuronium. All measurements were conducted before, during and after recovery from a period of intense NMB. Baseline values were VO(2) 6.1 ml/(kg min) (SD 1.3), comfort score 13 (SD 0.7), BIS 42.5 (SD 14.2), mean blood pressure 54.0 mmHg (SD 10.5), mean heart rate 129.9 bpm (SD 28.9) and mean core temperature 36.7 degrees C (SD 0.5). There were no significant differences in VO(2) or other parameters between baseline, during NMB and the recovery phase. CONCLUSION:Neuromuscular blocking agents do not reduce oxygen consumption in deeply sedated and mechanically ventilated children after congenital cardiac surgery.

journal_name

Intensive Care Med

journal_title

Intensive care medicine

authors

Lemson J,Driessen JJ,van der Hoeven JG

doi

10.1007/s00134-008-1252-z

subject

Has Abstract

pub_date

2008-12-01 00:00:00

pages

2268-72

issue

12

eissn

0342-4642

issn

1432-1238

journal_volume

34

pub_type

杂志文章
  • Noninvasive ventilation for treating acute respiratory failure in AIDS patients with Pneumocystis carinii pneumonia.

    abstract:OBJECTIVE:To compare noninvasive positive pressure ventilation (NPPV) vs. invasive mechanical ventilation in AIDS patients with Pneumocystis carinii pneumonia (PCP)-related acute respiratory failure (ARF). DESIGN:A single-center, prospective, case-control trial. SETTING:An ICU of a private tertiary hospital specializ...

    journal_title:Intensive care medicine

    pub_type: 临床试验,杂志文章

    doi:10.1007/s00134-002-1395-2

    authors: Confalonieri M,Calderini E,Terraciano S,Chidini G,Celeste E,Puccio G,Gregoretti C,Meduri GU

    更新日期:2002-09-01 00:00:00

  • End-of-life decision making in the intensive care unit.

    abstract::Physicians are increasingly involved in how their critically ill patients die [72]. The more this happens, the more physicians will have to understand not only how their own backgrounds and biases influence their medical management, but also the cultural and religious backgrounds of the patient and surrogate [72, 73]....

    journal_title:Intensive care medicine

    pub_type: 杂志文章,评审

    doi:10.1007/s001340000641

    authors: Nyman DJ,Sprung CL

    更新日期:2000-10-01 00:00:00

  • The continuous monitoring of CO2 ductances in pulmonary intensive care.

    abstract::A cardiorespiratory monitoring system allows the measurement of FAECO2 and FECO2 in the expired air of the patient at the mouth (endtidal CO2) and in a mixing box. From these parameters, combined with the measured PACO2, the alveolo-expired (DuA = PECO2/PAECO2) and alveolar-arterial (Dua = PAECO2/PACO2) ductances whic...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/BF01687162

    authors: Polu JM,Duvivier C,Sadoul P

    更新日期:1980-08-01 00:00:00

  • Influence of tidal volume on left ventricular stroke volume variation measured by pulse contour analysis in mechanically ventilated patients.

    abstract:OBJECTIVE:Real-time measurement of stroke volume variation by arterial pulse contour analysis (SVV) is useful in predicting volume responsiveness and monitoring volume therapy in mechanically ventilated patients. This study investigated the influence of the depth of tidal volume (V(t)) on SVV both during the state of f...

    journal_title:Intensive care medicine

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1007/s00134-003-1649-7

    authors: Reuter DA,Bayerlein J,Goepfert MS,Weis FC,Kilger E,Lamm P,Goetz AE

    更新日期:2003-03-01 00:00:00

  • Plasma and lung concentrations of ceftazidime administered in continuous infusion to critically ill patients with severe nosocomial pneumonia.

    abstract:OBJECTIVE:To determine the steady-state plasma and epithelial lining fluid (ELF) concentrations of ceftazidime administered in continuous infusion to critically ill patients with severe nosocomial pneumonia. DESIGN:Prospective, open-label study. SETTING:An intensive care unit and research ward in a university hospita...

    journal_title:Intensive care medicine

    pub_type: 临床试验,杂志文章

    doi:10.1007/s00134-004-2171-2

    authors: Boselli E,Breilh D,Rimmelé T,Poupelin JC,Saux MC,Chassard D,Allaouchiche B

    更新日期:2004-05-01 00:00:00

  • Measurement of lung volume in mechanically ventilated monkeys with an ultrasonic flow meter and the nitrogen washout method.

    abstract:OBJECTIVE:Measurement of functional residual capacity (FRC) during mechanical ventilation is important to standardise respiratory system compliance and adjust the ventilator settings to optimise lung recruitment. In the present study we compared three methods to measure FRC. DESIGN:The bias flow nitrogen washout techn...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/s00134-003-2028-0

    authors: Schibler A,Hammer J,Isler R,Buess C,Newth CJ

    更新日期:2004-01-01 00:00:00

  • Time course of lung injury in rat acute pancreatitis.

    abstract:OBJECTIVE:Lung injury is a severe complication of acute pancreatitis that increases the mortality rate of the disease. The pathophysiology of acute pancreatitis has been studied in several experimental models, but the kinetics of pulmonary complications in relation to the pancreatic disease is not completely understood...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/s00134-006-0264-9

    authors: Morel DR,Frossard JL,Cikirikcioglu B,Tapponnier M,Pastor CM

    更新日期:2006-11-01 00:00:00

  • Intrathecal baclofen in tetanus: four cases and a review of reported cases.

    abstract:OBJECTIVE:Spasms in patients with generalized tetanus can be suppressed by a spinal intrathecal infusion of baclofen. We report on four patients and review reported cases treated by this method elsewhere. DESIGN:Intrathecal baclofen infusion was started with a bolus dose (300-500 micrograms) and continued at a steady ...

    journal_title:Intensive care medicine

    pub_type: 杂志文章,评审

    doi:10.1007/s001340050429

    authors: Dressnandt J,Konstanzer A,Weinzierl FX,Pfab R,Klingelhöfer J

    更新日期:1997-08-01 00:00:00

  • In vitro activity of fleroxacin against multiresistant gram-negative bacilli isolated from patients with nosocomial infections.

    abstract::In order to evaluate the in vitro activity of fleroxacin against nosocomial gram-negative organisms, 263 multiresistant gram-negative bacilli (203 Enterobacteriaceae and 60 non-fermenting gram-negative bacilli) were isolated from adult patients with nosocomial infections. The different patterns of resistance to eight ...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/s001340050675

    authors: Araque M,Velazco E

    更新日期:1998-08-01 00:00:00

  • The impact of early goal-directed fluid management on survival in an experimental model of severe acute pancreatitis.

    abstract:PURPOSE:Severe acute pancreatitis (SAP) remains a life-threatening disease with classic etiology of systemic inflammatory response and mortality between 30 and 50 %. The aim of the present study is to compare two different treatment strategies of goal-directed hemodynamic management and evaluate their impact on surviva...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/s00134-012-2775-x

    authors: Trepte CJ,Bachmann KA,Stork JH,Friedheim TJ,Hinsch A,Goepfert MS,Mann O,Izbicki JR,Goetz AE,Reuter DA

    更新日期:2013-04-01 00:00:00

  • ARDS and knowledge translation.

    abstract::Knowledge translation is an important step for translational research. In this issue of Intensive Care Medicine, a new mini-series of basic research-related reviews is published. Three invited reviews focus on the role of extracellular matrix in ventilator-induced lung injury and mechanotransduction. The major challen...

    journal_title:Intensive care medicine

    pub_type: 评论,社论

    doi:10.1007/s00134-007-0965-8

    authors: Liu M

    更新日期:2008-04-01 00:00:00

  • Effect of changes over time in the performance of a customized SAPS-II model on the quality of care assessment.

    abstract:PURPOSE:The aim of our study was to explore, using an innovative method, the effect of temporal changes in the mortality prediction performance of an existing model on the quality of care assessment. The prognostic model (rSAPS-II) was a recalibrated Simplified Acute Physiology Score-II model developed for very elderly...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/s00134-011-2390-2

    authors: Minne L,Eslami S,de Keizer N,de Jonge E,de Rooij SE,Abu-Hanna A

    更新日期:2012-01-01 00:00:00

  • Effect of low-level PEEP on inspiratory work of breathing in intubated patients, both with healthy lungs and with COPD.

    abstract:OBJECTIVE:Evaluation of low-level PEEP (5 cm H2O) and the two different CPAP trigger modes in the Bennett 7200a ventilator (demand-valve and flow-by trigger modes) on inspiratory work of breathing (Wi) during the weaning phase. DESIGN:Prospective controlled study. SETTING:The intensive care unit of a university hospi...

    journal_title:Intensive care medicine

    pub_type: 临床试验,杂志文章

    doi:10.1007/BF01712329

    authors: Sydow M,Golisch W,Buscher H,Zinserling J,Crozier TA,Burchardi H

    更新日期:1995-11-01 00:00:00

  • Relationships between markers of neurologic and endothelial injury during critical illness and long-term cognitive impairment and disability.

    abstract:PURPOSE:Neurologic and endothelial injury biomarkers are associated with prolonged delirium during critical illness and may reflect injury pathways that lead to poor long-term outcomes. We hypothesized that blood-brain barrier (BBB), neuronal, and endothelial injury biomarkers measured during critical illness are assoc...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/s00134-018-5120-1

    authors: Hughes CG,Patel MB,Brummel NE,Thompson JL,McNeil JB,Pandharipande PP,Jackson JC,Chandrasekhar R,Ware LB,Ely EW,Girard TD

    更新日期:2018-03-01 00:00:00

  • Acute adrenal insufficiency resulting from adrenal hemorrhage as indicated by post-operative hypotension.

    abstract::We examined the incidence, diagnosis and therapy of acute adrenal insufficiency, secondary to adrenal hemorrhage. This insufficiency resulted in temperature irregularities. hemodynamic instability, and a large volume resuscitation requirement post-operatively. The case illustrates that a high level of suspicion should...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/BF01704704

    authors: Szalados JE,Vukmir RB

    更新日期:1994-01-01 00:00:00

  • Hemodynamic and gas exchange responses to inhalation of nitric oxide in patients with the acute respiratory distress syndrome and in hypoxemic patients with chronic obstructive pulmonary disease.

    abstract:OBJECTIVE:Inhalation of nitric oxide (NO) can improve oxygenation and decrease mean pulmonary artery pressure (MPAP) in patients with the acute respiratory distress syndrome (ARDS). It is not known whether inhaled NO exerts a similar effect in hypoxemic patients with chronic obstructive pulmonary disease (COPD). DESIG...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/s001340050290

    authors: Blanch L,Joseph D,Fernández R,Mas A,Martinez M,Vallés J,Diaz E,Baigorri F,Artigas A

    更新日期:1997-01-01 00:00:00

  • Modulation of rat brain synaptosomal plasma membrane achieved by atracurium and its metabolite laudanosine.

    abstract:OBJECTIVE:Atracurium besylate and laudanosine cause excitement and seizures when introduced into the central nervous system of laboratory animals. We examined the modulation of lipid-protein interaction in the lipid environment of rat brain synaptosomal plasma membrane (SPM)-bound enzymes as a possible mechanism leadin...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/s001340050605

    authors: Kamper EF,Siafaka J,Stavridis J

    更新日期:1998-05-01 00:00:00

  • Very high volume hemofiltration with the Cascade system in septic shock patients.

    abstract:PURPOSE:We compared hemodynamic and biological effects of the Cascade system, which uses very high volume hemofiltration (HVHF) (120 mL kg(-1) h(-1)), with those of usual care in patients with septic shock. METHODS:Multicenter, prospective, randomized, open-label trial in three intensive care units (ICU). Adults with ...

    journal_title:Intensive care medicine

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1007/s00134-015-4056-y

    authors: Quenot JP,Binquet C,Vinsonneau C,Barbar SD,Vinault S,Deckert V,Lemaire S,Hassain AA,Bruyère R,Souweine B,Lagrost L,Adrie C

    更新日期:2015-12-01 00:00:00

  • Inter-observer variability in APACHE II scoring: effect of strict guidelines and training.

    abstract:OBJECTIVE:To assess the effect of strict guidelines and a rigorous training program on variability in scoring the revised Acute Physiology and Chronic Health Evaluation (APACHE II). DESIGN AND SETTING:Prospective survey and intervention in the surgical ICU of a university teaching hospital. MEASUREMENTS:Seven experie...

    journal_title:Intensive care medicine

    pub_type: 临床试验,杂志文章

    doi:10.1007/s001340101012

    authors: Polderman KH,Jorna EM,Girbes AR

    更新日期:2001-08-01 00:00:00

  • How many patients with severe sepsis are needed to confirm the efficacy of drotrecogin alfa activated? A Bayesian design.

    abstract:OBJECTIVES:Controversies concerning the pivotal trial and negative results from other Drotrecogin alfa activated (DAA) trials have raised questions about its efficacy in severe sepsis patients. Based on all available evidence, our study aimed to respond to: (1) What is the current probability that DAA is not better tha...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/s00134-008-1159-8

    authors: Kalil AC,Sun J

    更新日期:2008-10-01 00:00:00

  • Early organ dysfunction course, cooling time and outcome in classic heatstroke.

    abstract:PURPOSE:To describe the course of early organ dysfunction in a cohort of patients admitted in ICU suffering classic heatstroke. METHODS:Prospective observational single-centre cohort study with a 1-year follow-up. INTERVENTIONS:None. MEASUREMENTS AND MAIN RESULTS:Clinical and biological data of 22 patients were anal...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/s00134-009-1500-x

    authors: Pease S,Bouadma L,Kermarrec N,Schortgen F,Régnier B,Wolff M

    更新日期:2009-08-01 00:00:00

  • Thiamine status after major trauma.

    abstract::A prospective study of thiamine status in patients with severe injuries (injury severity scores greater than 12) showed that they all developed signs of severe thiamine deficiency on the basis of transketolase activity, the standard biochemical test for thiamine deficiency. This occurred within the first week after th...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/BF00256767

    authors: McConachie I,Haskew A

    更新日期:1988-01-01 00:00:00

  • Metabolic arrest.

    abstract::In hypoxia sensitive cells and tissues, the rates of glucose and O2 consumption are inversely related (Pasteur Effect). Under O2 limiting conditions the demands for glucose (glycogen) in such cells may drastically rise as a means for maintaining ATP turnover close to normoxic rates; nevertheless ion and electrical pot...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/BF00254926

    authors: Hochachka PW

    更新日期:1986-01-01 00:00:00

  • Comparison of atracurium and pancuronium in mechanically ventilated neonates.

    abstract:OBJECTIVE:To compare haemodynamic and gas exchange effects after either atracurium or pancuronium given to ventilated neonates with respiratory failure. DESIGN:In this prospective study neonates were alternately assigned to receive either atracurium or pancuronium, intravenously. SETTING:Paediatric and neonatal ICU i...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/BF01724880

    authors: Piotrowski A

    更新日期:1993-01-01 00:00:00

  • Effect of cerebral perfusion pressure augmentation with dopamine and norepinephrine on global and focal brain oxygenation after traumatic brain injury.

    abstract:OBJECTIVE:To compare the effects of a cerebral perfusion pressure (CPP) intervention achieved with dopamine and norepinephrine after severe head injury. DESIGN:Prospective, controlled, trial. SETTING:Neurosciences critical care unit. PATIENTS:Eleven patients with a head injury, requiring dopamine or norepinephrine i...

    journal_title:Intensive care medicine

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1007/s00134-003-2155-7

    authors: Johnston AJ,Steiner LA,Chatfield DA,Coles JP,Hutchinson PJ,Al-Rawi PG,Menon DK,Gupta AK

    更新日期:2004-05-01 00:00:00

  • Volumetric capnography as a bedside monitoring of thrombolysis in major pulmonary embolism.

    abstract:OBJECTIVE:To describe the use of volumetric capnography, a plot of expired CO(2) concentration against expired volume, in monitoring fibrinolytic treatment of major pulmonary embolism. DESIGN AND SETTING:Two case reports in the emergency department of a teaching hospital. PATIENTS:Two conscious and spontaneously brea...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/s00134-004-2444-9

    authors: Verschuren F,Heinonen E,Clause D,Roeseler J,Thys F,Meert P,Marion E,El Gariani A,Col J,Reynaert M,Liistro G

    更新日期:2004-11-01 00:00:00

  • Left ventricular systolic dysfunction during septic shock: the role of loading conditions.

    abstract:PURPOSE:The clinical significance of septic myocardial dysfunction is controversial, a fact that may be explained by the influence of loading conditions. Many indices may be useful to characterize cardiac function during septic shock, but their feasibility and physiological coherence in the clinical setting are unknown...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/s00134-017-4698-z

    authors: Boissier F,Razazi K,Seemann A,Bedet A,Thille AW,de Prost N,Lim P,Brun-Buisson C,Mekontso Dessap A

    更新日期:2017-05-01 00:00:00

  • Prevention of colonization and respiratory infections in long-term ventilated patients by local antimicrobial prophylaxis.

    abstract::In a randomized clinical trial the prophylactic effects of locally administered antimicrobials on quantitative colonization and respiratory infections were studied in intubated patients with an expected period of mechanical ventilation of greater than 6 days. Nineteen patients received 50 mg of polymyxin B and 80 mg o...

    journal_title:Intensive care medicine

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1007/BF00254795

    authors: Unertl K,Ruckdeschel G,Selbmann HK,Jensen U,Forst H,Lenhart FP,Peter K

    更新日期:1987-01-01 00:00:00

  • Specialist neurocritical care and outcome from head injury.

    abstract:OBJECTIVES:To document the effect of neurocritical care, delivered by specialist staff and based on protocol-driven therapy aimed at intracranial pressure (ICP) and cerebral perfusion pressure (CPP) targets, on outcome in acute head injury. DESIGN:Retrospective record review to compare presentation, therapy and outcom...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/s00134-002-1235-4

    authors: Patel HC,Menon DK,Tebbs S,Hawker R,Hutchinson PJ,Kirkpatrick PJ

    更新日期:2002-05-01 00:00:00

  • Terlipressin dose response in healthy and endotoxemic sheep: impact on cardiopulmonary performance and global oxygen transport.

    abstract:OBJECTIVE:To determine whether a goal-directed terlipressin infusion increases mean arterial pressure without causing a pulmonary vasopressive effect and whether this response impacts on key parameters of oxygen transport in healthy and endotoxemic sheep. DESIGN AND SETTING:Prospective controlled trial in a university...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/s00134-002-1546-5

    authors: Westphal M,Stubbe H,Sielenkämper AW,Borgulya R,Van Aken H,Ball C,Bone HG

    更新日期:2003-02-01 00:00:00