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Neuromuscular block

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https://www.readbyqxmd.com/read/29351759/tracheal-intubation-in-critically-ill-patients-a-comprehensive-systematic-review-of-randomized-trials
#1
Luca Cabrini, Giovanni Landoni, Martina Baiardo Radaelli, Omar Saleh, Carmine D Votta, Evgeny Fominskiy, Alessandro Putzu, Cézar Daniel Snak de Souza, Massimo Antonelli, Rinaldo Bellomo, Paolo Pelosi, Alberto Zangrillo
BACKGROUND: We performed a systematic review of randomized controlled studies evaluating any drug, technique or device aimed at improving the success rate or safety of tracheal intubation in the critically ill. METHODS: We searched PubMed, BioMed Central, Embase and the Cochrane Central Register of Clinical Trials and references of retrieved articles. Finally, pertinent reviews were also scanned to detect further studies until May 2017. The following inclusion criteria were considered: tracheal intubation in adult critically ill patients; randomized controlled trial; study performed in Intensive Care Unit, Emergency Department or ordinary ward; and work published in the last 20 years...
January 20, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29348419/dysbindin-links-presynaptic-proteasome-function-to-homeostatic-recruitment-of-low-release-probability-vesicles
#2
Corinna Wentzel, Igor Delvendahl, Sebastian Sydlik, Oleg Georgiev, Martin Müller
Here we explore the relationship between presynaptic homeostatic plasticity and proteasome function at the Drosophila neuromuscular junction. First, we demonstrate that the induction of homeostatic plasticity is blocked after presynaptic proteasome perturbation. Proteasome inhibition potentiates release under baseline conditions but not during homeostatic plasticity, suggesting that proteasomal degradation and homeostatic plasticity modulate a common pool of vesicles. The vesicles that are regulated by proteasome function and recruited during homeostatic plasticity are highly EGTA sensitive, implying looser Ca2+ influx-release coupling...
January 18, 2018: Nature Communications
https://www.readbyqxmd.com/read/29343142/a-500%C3%A2-u-2%C3%A2-ml-dilution-of-abobotulinumtoxina-vs-placebo-randomized-study-in-cervical-dystonia
#3
Mark F Lew, Allison Brashear, Khashayar Dashtipour, Stuart Isaacson, Robert A Hauser, Pascal Maisonobe, Daniel Snyder, William Ondo
Purpose/aim: AbobotulinumtoxinA (Dysport®, Ipsen Biopharmaceuticals, Inc., Basking Ridge, NJ, USA) is an acetylcholine release inhibitor and a neuromuscular blocking agent. The United States prescribing information for abobotulinumtoxinA previously indicated only one dilution for cervical dystonia: 500 U/1 mL. Clinical trial data supporting a larger volume with a 500 U/2 mL dilution would offer clinicians flexibility with injection volume to better meet patient needs. MATERIALS AND METHODS: We conducted a 12-week, phase 3b, multicenter, randomized, double-blind, placebo-controlled trial (NCT01753310)...
January 17, 2018: International Journal of Neuroscience
https://www.readbyqxmd.com/read/29338895/feasibility-of-total-intravenous-anesthesia-by-cardiologists-with-the-support-of-anesthesiologists-during-catheter-ablation-of-atrial-fibrillation
#4
Takanori Yamaguchi, Yusuke Shimakawa, Shinji Mitsumizo, Akira Fukui, Yuki Kawano, Toyokazu Otsubo, Yuya Takahashi, Kei Hirota, Takeshi Tsuchiya, Kenichi Eshima
BACKGROUND: The optimal methodology for sedation and anesthesia during atrial fibrillation (AF) ablation has not been well established. We assessed the feasibility of total intravenous anesthesia (TIVA) by cardiologists with support from anesthesiologists during AF ablation and quality of pulmonary vein isolation (PVI) and single procedure success rate at 12 months. METHODS: TIVA was performed by cardiologists using IV propofol and fentanyl under controlled ventilation via i-gel™ without neuromuscular blocking drugs in 160 consecutive patients (80 nonparoxysmal) with no anticipated difficult airway or other severe diseases...
January 12, 2018: Journal of Cardiology
https://www.readbyqxmd.com/read/29326174/muscle-nicotinic-acetylcholine-receptors-may-mediate-trans-synaptic-signaling-at-the-mouse-neuromuscular-junction
#5
Xueyong Wang, J Michael McIntosh, Mark M Rich
Block of neurotransmitter receptors at the neuromuscular junction (NMJ) has been shown to trigger upregulation of the number of synaptic vesicles released (quantal content, QC), a response termed homeostatic synaptic plasticity. The mechanism underlying this plasticity is not known. Here, we used selective toxins to demonstrate that block of α1-containing nicotinic acetylcholine receptors (nAChRs) at the neuromuscular junction of male and female mice, triggers the upregulation of QC. Reduction of current flow through nAChRs, induced by drugs with antagonist activity, demonstrated that reduction in synaptic current per se does not trigger upregulation of QC...
January 11, 2018: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/29324904/prohibitin-plays-a-critical-role-in-enterovirus-71-neuropathogenesis
#6
Issac Horng Khit Too, Isabelle Bonne, Eng Lee Tan, Justin Jang Hann Chu, Sylvie Alonso
A close relative of poliovirus, enterovirus 71 (EV71) is regarded as an important neurotropic virus of serious public health concern. EV71 causes Hand, Foot and Mouth Disease and has been associated with neurological complications in young children. Our limited understanding of the mechanisms involved in its neuropathogenesis has hampered the development of effective therapeutic options. Here, using a two-dimensional proteomics approach combined with mass spectrometry, we have identified a unique panel of host proteins that were differentially and dynamically modulated during EV71 infection of motor-neuron NSC-34 cells, which are found at the neuromuscular junctions where EV71 is believed to enter the central nervous system...
January 2018: PLoS Pathogens
https://www.readbyqxmd.com/read/29324189/is-cisatracurium-the-neuromuscular-blocking-agent-of-choice-in-ards
#7
David T Huang, Laurent Papazian
No abstract text is available yet for this article.
January 11, 2018: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29323161/lack-of-fgf18-causes-abnormal-clustering-of-motor-nerve-terminals-at-the-neuromuscular-junction-with-reduced-acetylcholine-receptor-clusters
#8
Kenyu Ito, Bisei Ohkawara, Hideki Yagi, Hiroaki Nakashima, Mikito Tsushima, Kyotaro Ota, Hiroyuki Konishi, Akio Masuda, Shiro Imagama, Hiroshi Kiyama, Naoki Ishiguro, Kinji Ohno
FGF receptor 2 is involved in the formation of the neuromuscular junction (NMJ), but its in vivo ligand remains to be determined. Laser capture microdissection of the mouse spinal motor neurons (SMNs) revealed that Fgf18 mRNA is highly expressed in SMNs in adults. Expression of Fgf18 mRNA was the highest in the spinal cord at embryonic day (E) 15.5, which gradually decreased to postnatal day 7. FGF18 protein was localized at the NMJs of the tibialis anterior muscle at E18.5 and in adults. Fgf18-/- mice at E18...
January 11, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29317806/profile-of-sugammadex-for-reversal-of-neuromuscular-blockade-in-the-elderly-current-perspectives
#9
REVIEW
Michele Carron, Francesco Bertoncello, Giovanna Ieppariello
The number of elderly patients is increasing worldwide. This will have a significant impact on the practice of anesthesia in future decades. Anesthesiologists must provide care for an increasing number of elderly patients, who have an elevated risk of perioperative morbidity and mortality. Complications related to postoperative residual neuromuscular blockade, such as muscle weakness, airway obstruction, hypoxemia, atelectasis, pneumonia, and acute respiratory failure, are more frequent in older than in younger patients...
2018: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/29317084/-reversal-of-neuromuscular-block-with-sugammadex-in-five-heart-transplant-pediatric-recipients
#10
Ricardo Vieira Carlos, Marcelo Luis Abramides Torres, Hans Donald de Boer
Heart transplantation is a frequent procedure in the treatment of end-stage cardiac dysfunction. Therefore, these patient populations will also be more frequent exposed to other more common surgical procedures after their transplantation. Anesthesiologist should be aware in their assessment of these patients, especially regarding some specific issues related to patients with a history of heart transplantation, like reversal of neuromuscular block. Several reports described that cholinesterase inhibitors drugs, like neostigmine, may produce a dose-dependent life-threatening bradycardia in heart transplant recipients while other publication described the safe use of neostigmine...
January 6, 2018: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/29305081/extending-knowledge-of-the-clinical-picture-of-balkan-adder-vipera-berus-bosniensis-envenoming-the-first-photographically-documented-neurotoxic-case-from-south-western-hungary
#11
Csaba Varga, Tamás Malina, Viktória Alföldi, Gergely Bilics, Ferenc Nagy, Tibor Oláh
We report a severe envenoming associated with minimal local symptoms following a Balkan adder (Vipera berus bosniensis) bite in South-Western Hungary. A 63-year-old male with a history of hypertension and sinus bradycardia (45/min) was bitten by a sub-adult specimen of V. b. bosniensis in Somogy County on 04 May 2017. The patient was transported to and treated at the Emergency Department of Somogy County "Moritz Kaposi" General Hospital, Kaposvár. Locally only pain and minimal swelling with a small haematoma developed on the bitten finger...
January 2, 2018: Toxicon: Official Journal of the International Society on Toxinology
https://www.readbyqxmd.com/read/29280254/characterization-of-the-functional-near-infrared-spectroscopy-response-to-nociception-in-a-pediatric-population
#12
Vanessa A Olbrecht, Yifei Jiang, Luigi Viola, Charlotte M Walter, Hanli Liu, Charles D Kurth
BACKGROUND: Near-infrared spectroscopy can interrogate functional optical signal changes in regional brain oxygenation and blood volume to nociception analogous to functional magnetic resonance imaging. AIMS: This exploratory study aimed to characterize the near-infrared spectroscopy signals for oxy-, deoxy-, and total hemoglobin from the brain in response to nociceptive stimulation of varying intensity and duration, and after analgesic and neuromuscular paralytic in a pediatric population...
December 27, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29241014/an-observational-study-of-the-efficacy-of-cisatracurium-compared-to-vecuronium-in-patients-with-or-at-risk-for-ards
#13
Peter D Sottile, Tyree H Kiser, Ellen L Burnham, P Michael Ho, Richard R Allen, R William Vandivier, Marc Moss
RATIONALE: The neuromuscular blocking agent cisatracurium may improve mortality for patients with moderate-severe ARDS. Other neuromuscular blocking agents, such as vecuronium, are commonly used and have different mechanisms of action, side effects, cost, and availability in the setting of drug shortages. OBJECTIVE: To determine whether cisatracurium is associated with improved outcomes when compared vecuronium in patients at risk for and with ARDS. METHODS: Using a nationally representative database, patients admitted to the intensive care unit (ICU) with a diagnosis of ARDS or an ARDS risk factor, received mechanical ventilation, and were treated with a continuous infusion of neuromuscular blocking agent for at least two days within two days of hospital admission were included...
December 14, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29239154/neuromuscular-block-in-laparoscopic-surgery
#14
Thomas Fuchs-Buder, Edoardo DE Robertis, Laurent Brunaud
BACKGROUND: There is an increased interest in the current literature to evaluate the potential clinical benefit of a sustained deep neuromuscular blockade ( i.e. a post-tetanic count ≤ 3) during various laparoscopic surgical procedures. This deep block concept represents a new area of clinical research, which concerns both, anesthesiologists and surgeons. METHODS: We reviewed a selection of recent publications about the indications and the potential benefits of a maintained deep neuromuscular blockade during different laparoscopic procedures...
December 13, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29236668/-claude-bernard-and-nicotinic-receptors-from-the-neuromuscular-junction-to-tobacco-weaning
#15
Laurent Monassier
Claude Bernard (1813-1878) was fascinated by the pharmacological mechanisms of poisons. In particular, using a huge amount of ingenious and robust experiments, he demonstrated the peripheral toxic action of the natural compound curare. His work generated controversies in a period where scientific methodology and technical development followed the progression of concepts and ideas. From his intense debates with Albert Vulpian emerged the location of curare's toxicity at the neuromuscular junction. These two fascinating scientists could not imagine how important were these discoveries which allowed John Langley to propose the concept of receptor early in the 20th century...
2017: Biologie Aujourd'hui
https://www.readbyqxmd.com/read/29226915/erratum-factors-that-affect-the-onset-of-action-of-non-depolarizing-neuromuscular-blocking-agents
#16
Yong Beom Kim, Tae-Yun Sung, Hong Seuk Yang
[This corrects the article on p. 500 in vol. 70, PMID: 29046769.].
December 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29217857/a-comparison-of-haemodynamic-responses-between-clinical-assessment-guided-tracheal-intubation-and-neuromuscular-block-monitoring-guided-tracheal-intubation-a-prospective-randomised-study
#17
Rudranil Nandi, Shekhar Ranjan Basu, Susanta Sarkar, Rakesh Garg
Background and Aims: Haemodynamic responses to laryngoscopy and endotracheal intubation and their hazards are well documented. The purpose of the study was to compare the effects of laryngoscopy and intubation on cardiovascular responses when the appropriate moment for intubation was directed by either clinical judgment or train-of-four assessment. Methods: A total of 68 patients, posted for laparoscopic cholecystectomy, were randomised into two groups. In Group M patients, the trachea was intubated after train of four counts became zero in adductor pollicis muscle, whereas in Group C patients, the trachea was intubated after the clinical judgment of jaw muscle relaxation...
November 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29216820/comparison-of-the-effect-of-different-infusion-rates-of-sufentanil-on-surgical-stress-index-during-cranial-pinning-in-children-under-general-anaesthesia-a-randomized-controlled-study
#18
In-Kyung Song, Sang-Hwan Ji, Eun-Hee Kim, Ji-Hyun Lee, Jin-Tae Kim, Hee-Soo Kim
BACKGROUND: Surgical stress index (SSI) is an established indicator for intraoperative nociception. Opioids are used to block stimulus of cranial pinning in neurosurgery. We investigated the effect of different infusion rates of sufentanil on SSI during cranial pinning in children under general anaesthesia. METHODS: Forty-nine children (2-12 years of age) underwent neurosurgery with pinning. The children were randomized into three groups based on the rate of sufentanil infusion: 0...
December 8, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/29214645/recovery-characteristics-of-patients-receiving-either-sugammadex-or-neostigmine-and-glycopyrrolate-for-reversal-of-neuromuscular-block-a-randomised-controlled-trial
#19
M J Paech, R Kaye, C Baber, E A Nathan
Sugammadex more rapidly and reliably reverses rocuronium-induced neuromuscular block compared with neostigmine, but it is not known if subsequent patient outcomes, including nausea, vomiting and other aspects of recovery are modified. In this study, we compared the recovery characteristics of sugammadex and neostigmine/glycopyrrolate following reversal of neuromuscular block. This was a single-centre, randomised, blinded, parallel-group clinical trial in women undergoing elective day-surgical laparoscopic gynaecological surgery, with a standardised general anaesthesia regimen that included rocuronium...
December 7, 2017: Anaesthesia
https://www.readbyqxmd.com/read/29214627/a-12-month-descriptive-analysis-of-emergency-intubations-at-brooke-army-medical-center-a-national-emergency-airway-registry-study
#20
Michael D April, Steven G Schauer, Calvin A Brown Rd, Patrick C Ng, Jessie Fernandez, Andrea E Fantegrossi, Joseph K Maddry, Shane Summers, Daniel J Sessions, Robert M Barnwell, Mark Antonacci
Emergency airway management is a critical skill for military healthcare providers. Our goal was to describe the Emergency Department (ED) intubations at Brooke Army Medical Center (BAMC) over a 12-month period. MATERIAL AND METHODS: Physicians performing endotracheal intubations in the BAMC ED complete data collection forms for each intubation event as part of the National Emergency Airway Registry, including patient demographics, intubation techniques, success and failure rates, adverse events, and patient disposition...
October 2017: U.S. Army Medical Department Journal
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