Abstract:
:We cared for a 4-year-old patient who had undergone orthotopic liver transplantation and was placed on a ventilator for respiratory distress associated with Pneumocystis carinii pneumonia. The neuromuscular blocking agent pancuronium bromide 1.0-1.2 mg every hour as needed was used to facilitate artificial ventilation for 40 days. On discontinuation of pancuronium, the patient experienced severe, generalized neuromuscular dysfunction. Because no improvement was seen for 2 weeks, the acetylcholinesterase inhibitors edrophonium and pyridostigmine were instituted. Shortly thereafter the patient's condition began to improve. Gradual improvement occurred over 3-4 months and the patient has since returned to baseline neurologic function. We suggest that long-term pancuronium use was the cause of the patient's prolonged paralysis. The improvement experienced after the initiation of antidotal therapy strongly supports our proposal.
journal_name
Pharmacotherapyjournal_title
Pharmacotherapyauthors
Haas JL,Shaefer MS,Miwa LJ,Wood RP,Shaw BW Jrdoi
10.1002/j.1875-9114.1989.tb04121.xsubject
Has Abstractpub_date
1989-01-01 00:00:00pages
154-7issue
3eissn
0277-0008issn
1875-9114journal_volume
9pub_type
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