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neuromuscular blockade

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https://www.readbyqxmd.com/read/28212163/multiple-organ-dysfunction-in-children-mechanically-ventilated-for-acute-respiratory-failure
#1
Scott L Weiss, Lisa A Asaro, Heidi R Flori, Geoffrey L Allen, David Wypij, Martha A Q Curley
OBJECTIVES: The impact of extrapulmonary organ dysfunction, independent from sepsis and lung injury severity, on outcomes in pediatric acute respiratory failure is unclear. We sought to determine the frequency, timing, and risk factors for extrapulmonary organ dysfunction and the independent association of multiple organ dysfunction syndrome with outcomes in pediatric acute respiratory failure. DESIGN: Secondary observational analysis of the Randomized Evaluation of Sedation Titration for Respiratory Failure cluster-randomized prospective clinical trial conducted between 2009 and 2013...
February 16, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28210905/hypermagnesemia-disturbances-in-rats-no-related-pentadecapeptide-bpc-157-abrogates-l-name-and-l-arginine-worsen
#2
Maria Medvidovic-Grubisic, Vasilije Stambolija, Danijela Kolenc, Jadranka Katancic, Tamara Murselovic, Ivna Plestina-Borjan, Sanja Strbe, Domagoj Drmic, Ivan Barisic, Aleksandra Sindic, Sven Seiwerth, Predrag Sikiric
AIM: Stable gastric pentadecapeptide BPC 157, administered before a high-dose magnesium injection in rats, might be a useful peptide therapy against magnesium toxicity and the magnesium-induced effect on cell depolarization. Moreover, this might be an NO-system-related effect. Previously, BPC 157 counteracts paralysis, arrhythmias and hyperkalaemia, extreme muscle weakness; parasympathetic and neuromuscular blockade; injured muscle healing and interacts with the NOS-blocker and NOS-substrate effects...
February 16, 2017: Inflammopharmacology
https://www.readbyqxmd.com/read/28209997/antisense-mir-132-blockade-via-the-ache-r-splice-variant-mitigates-cortical-inflammation
#3
Nibha Mishra, Lyndon Friedson, Geula Hanin, Uriya Bekenstein, Meshi Volovich, Estelle R Bennett, David S Greenberg, Hermona Soreq
MicroRNA (miR)-132 brain-to-body messages suppress inflammation by targeting acetylcholinesterase (AChE), but the target specificity of 3'-AChE splice variants and the signaling pathways involved remain unknown. Using surface plasmon resonance (SPR), we identified preferential miR-132 targeting of soluble AChE-R over synaptic-bound AChE-S, potentiating miR-132-mediated brain and body cholinergic suppression of pro-inflammatory cytokines. Inversely, bacterial lipopolysaccharide (LPS) reduced multiple miR-132 targets, suppressed AChE-S more than AChE-R and elevated inflammatory hallmarks...
February 17, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28185260/a-comparison-of-sugammadex-and-neostigmine-for-reversal-of-rocuronium-induced-neuromuscular-blockade-in-children
#4
A S Ammar, K M Mahmoud, Z A Kasemy
BACKGROUND: Sugammadex is designed to be a reversal agent for steroidal muscle relaxants. The current trial was aimed to compare between sugammadex and neostigmine concerning the recovery time from neuromuscular blockade. We hypothesised that sugammadex might have shorter recovery time than neostigmine. METHODS: Sixty paediatric patients aged 2-10 years scheduled for lower abdominal surgeries were randomly assigned into two equal groups to receive 4 mg/kg sugammadex (Group S) or 0...
February 10, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28184275/postoperative-negative-pressure-pulmonary-edema-following-repetitive-laryngospasm-even-after-reversal-of-neuromuscular-blockade-by-sugammadex-a-case-report
#5
Ji Hyeon Lee, Jae Ho Lee, Min Hyun Lee, Hyun Oh Cho, Soon Eun Park
Laryngospasm, an occlusion of the glottis, can occur at any time during anesthesia, and is associated with serious perioperative complications such as hypoxia, hypercabia, aspiration, bronchospasm, arrhythmia, prolonged recovery, cardiac collapse, and eventually catastrophic death. Importantly, postoperative negative pressure pulmonary edema (NPPE) is a rare, but well described life-threatening complication related to acute and chronic upper airway obstruction. Sugammadex well known for affirmatively reducing the postoperative pulmonary complications associated with residual neuromuscular blockade may have an indirect role in triggering the negative intrathoracic pressure by raising a rapid and efficacious respiratory muscle strength in acute upper airway obstruction...
February 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28183581/chemotherapy-alters-cisatracurium-induced-neuromuscular-blockade-characteristics-a-prospective-cohort-study
#6
Amir Poya Zanjani, Maziar Maghsoudloo, Jalil Makarem, Fahimeh Farokhnia, Morteza Fazli, Zahid Hussain Khan
STUDY OBJECTIVE: To compare the characteristics of NMDR induced muscle paralysis in breast cancer patients with and without a history of recent chemotherapy with cyclophosphamide, doxorubicin and 5-fluorouracil (CAF) regimen. DESIGN: This is a non-randomized prospective cohort study. SETTING: Operating room of a university-affiliated teaching hospital. PATIENTS: Out of a total of 50 patients who had undergone mastectomy, 22 patients were allocated to the "Chemo group" and 28 patients to the "Non-Chemo group", based on a valid history of recent chemotherapy...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28183573/glycopyrrolate-it-s-time-to-review
#7
REVIEW
Jonathan Howard, Jason Wigley, Gerald Rosen, Jay D'mello
Medication shortages have become an all-too-common inconvenience that has forced anesthesia providers to examine our administering practices. Because of these shortages, commonly used medications are at the greatest risk. Glycopyrrolate (Robinul), which has been in short supply in recent years, is one of the most widely used anticholinergic agents, especially in conjunction with the anticholinesterase neostigmine, for reversal of neuromuscular blockade (NMB) drugs. Here we review multiple studies from 1972 through 1986 that used varying methods of patient selection and dosage and drug combination criteria, and which noted that glycopyrrolate had a superior efficacy and adverse effect profile when compared with atropine in NMB reversal...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28183558/frequency-of-inadequate-neuromuscular-blockade-during-general-anesthesia
#8
Timur Dubovoy, Amy M Shanks, Scott Devine, Sachin Kheterpal
STUDY OBJECTIVE: We used electronic health record data to define frequency of inadequate intraoperative neuromuscular blockade (NMB). DESIGN: Retrospective observational study using electronic health record data. SETTING: Operating room in a tertiary care academic hospital. PATIENTS: A total of 129,209 adult patients with American Society of Anesthesiologists physical status 1 to 5 undergoing general anesthesia in an outpatient or inpatient setting who received nondepolarizing NMB...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28183544/magnesium-sulfate-accelerates-the-onset-of-low-dose-rocuronium-in-patients-undergoing-laryngeal-microsurgery
#9
Eun-Su Choi, Woo-Jin Jeong, Soon-Hyun Ahn, Ah-Young Oh, Young-Tae Jeon, Sang-Hwan Do
STUDY OBJECTIVE: We evaluated the effect of magnesium sulfate-an enhancer of neuromuscular blockade-on onset and duration of low dose of rocuronium, and on operating conditions during laryngeal microsurgery. DESIGN: Randomized, prospective, double-blinded study. PATIENTS: Eighty-four patients scheduled for elective laryngeal microsurgery. INTERVENTIONS: Patients were randomly allocated to receive different doses of rocuronium: 0...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28166107/challenges-in-the-anesthetic-management-for-a-robotic-thymectomy-in-a-patient-with-myasthenia-gravis-a-case-report
#10
Susan M Martinelli, Bilal D Lateef, Jason M Long, David Y Huang, Ameeta Karmarkar, Brian P Barrick
We describe the case of a patient with myasthenia gravis undergoing a robotic-assisted thymectomy complicated by postoperative myasthenic crisis, with a focus on the anesthetic considerations specific to this case. Because myasthenia gravis is an autoimmune disease affecting acetylcholine receptors, caution must be taken with the use of neuromuscular blockade and reversal. Utilizing a robotic-assisted surgical approach makes anesthetic management challenging given the dangers of patient movement while the robot is docked, lung isolation, extubation criteria, and postoperative disposition...
February 3, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28151766/the-use-of-sugammadex-in-a-patient-with-guillain-barre-syndrome-a-case-report
#11
Büşra Tezcan, Demet Bölükbaş, Dilek Kazanc, Sema Turan, Gülseren Suer Kaya, Ayşegül Özgök
Sugammadex encapsulates and inactivates rocuronium and vecuronium. It is used to reverse neuromuscular blockade from these nondepolarizing agents. The safety of sugammadex in patients with neuromuscular disease has not been established. Guillain-Barre Syndrome (GBS) is a neuromuscular disease characterized by acute inflammatory polyneuropathy. Patients with GBS may exhibit autonomic dysfunction, chronic pain, abnormal reactions to neuromuscular blocking agents, and may require postoperative mechanical ventilation...
February 1, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28146382/respiratory-mechanics-in-a-patient-requiring-neuromuscular-blockade
#12
Robert C Stansbury, Joshua L Long, Edward L Petsonk
No abstract text is available yet for this article.
February 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28123622/full-outline-of-unresponsiveness-score-and-the-glasgow-coma-scale-in-prediction-of-pediatric-coma
#13
Atahar Jamal, Naveen Sankhyan, Murlidharan Jayashree, Sunit Singhi, Pratibha Singhi
BACKGROUND: This study was done to compare the admission Full Outline of Unresponsiveness (FOUR) score and Glasgow Coma Scale (GCS) as predictors of outcome in children with impaired consciousness. METHODS: In this observational study, children (5-12 years) with impaired consciousness of <7 days were included. Children with traumatic brain injury, on sedatives or neuromuscular blockade; with pre-existing cerebral palsy, mental retardation, degenerative brain disease, vision/hearing impairment; and seizure within last 1 hour were excluded...
2017: World Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28102521/clinical-assessment-and-train-of-four-measurements-in-critically-ill-patients-treated-with-recommended-doses-of-cisatracurium-or-atracurium-for-neuromuscular-blockade-a-prospective-descriptive-study
#14
Pierre Bouju, Jean-Marc Tadié, Nicolas Barbarot, Julien Letheulle, Fabrice Uhel, Pierre Fillatre, Guillaume Grillet, Angélique Goepp, Yves Le Tulzo, Arnaud Gacouin
BACKGROUND: Despite few studies, a monitoring of a neuromuscular blockade with a train of four (TOF) is recommended in intensive care unit (ICU). Our objective was to compare the results of ulnar and facial TOF measurements with an overall clinical assessment for neuromuscular blockade in ICU patients treated with recommended doses of atracurium or cisatracurium, including patients with acute respiratory disease syndrome (ARDS). METHODS: We prospectively included in two ICUs 119 patients, 94 with ARDS, who required a neuromuscular blockade for more than 24 h...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28101464/anti-inflammatory-and-antibothropic-properties-of-jatropha-elliptica-a-plant-from-brazilian-cerrado-biome
#15
Sára Cósta Ferreira-Rodrigues, Cássio Milhomens Rodrigues, Marcio Galdino Dos Santos, Jean Antonio Abraham Gautuz, Magali Glauzer Silva, José Carlos Cogo, Camila Batista-Silva, Cleiton Pita Dos Santos, Francisco Carlos Groppo, Karina Cogo-Müller, Yoko Oshima-Franco
Purpose: The aim of this study was to evaluate the antibothropic and anti-inflammatory properties of J. elliptica.Methods: Phytochemical screening and thin-layer chromatography (TLC) assays were performed on J. elliptica hydroalcoholic extract (TE) in order to observe its main constituents. The antibothropic activity of TE was evaluated by the in vitro neuromuscular blockade caused by Bothrops jararacussu venom (Bjssu), in a mouse phrenic nerve-diaphragm model (PND). A quantitative histological study was carried out to observe a possible protection of TE against the venom myotoxicity...
December 2016: Advanced Pharmaceutical Bulletin
https://www.readbyqxmd.com/read/28099321/preoxygenation-physiologic-basis-benefits-and-potential-risks
#16
Usharani Nimmagadda, M Ramez Salem, George J Crystal
Preoxygenation before anesthetic induction and tracheal intubation is a widely accepted maneuver, designed to increase the body oxygen stores and thereby delay the onset of arterial hemoglobin desaturation during apnea. Because difficulties with ventilation and intubation are unpredictable, the need for preoxygenation is desirable in all patients. During emergence from anesthesia, residual effects of anesthetics and inadequate reversal of neuromuscular blockade can lead to hypoventilation, hypoxemia, and loss of airway patency...
February 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28069681/clinical-practice-guidelines-for-sustained-neuromuscular-blockade-in-the-adult-critically-ill-patient-2016-update-executive-summary
#17
Michael J Murray, Heidi F DeBlock, Brian L Erstad, Anthony W Gray, Judith Jacobi, Ché J Jordan, William T McGee, Claire McManus, Maureen O Meade, Sean A Nix, Andrew J Patterson, Karen Sands, Richard M Pino, Ann N Tescher, Richard Arbour, Bram Rochwerg, Catherine Friederich Murray, Sangeeta Mehta
No abstract text is available yet for this article.
January 15, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28066625/the-anesthesia-of-trachea-and-bronchus-surgery
#18
REVIEW
Zehra Hatipoglu, Mediha Turktan, Alper Avci
The trachea and bronchus surgery is generally performed due to stenosis, traumatic injury, foreign body and tumors. Preoperative evaluation and anesthesia management are very important issues because of higher mortality and morbidity rates. Patients may be asymptomatic, but airway difficulties, hypoxia, stridor, cough, hemoptysis are common conditions in these patient population. The collaboration between the surgeon and the anesthesiologist is very substantial and necessary. Anesthetic techniques include various applications such as one lung ventilation, fiberoptic intubation, jet ventilation, and apneic oxygenation, general anesthesia with or without neuromuscular blockade...
November 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28058956/neuromuscular-blockade-and-inspiratory-breath-hold-during-stereotactic-body-radiation-therapy-for-treatment-of-heart-base-tumors-in-four-dogs
#19
Krista L Kelsey, Lyndsay N Kubicek, Nicholas J Bacon, Terry Torres, Sheilah A Robertson
CASE DESCRIPTION 4 dogs were examined because of pleural effusion and ventricular tachycardia, coughing and supraventricular tachycardia, appendicular osteosarcoma, and syncopal episodes. CLINICAL FINDINGS In all 4 dogs, a heart base tumor was identified by means of thoracic CT. TREATMENT AND OUTCOME In all 4 dogs, the heart base tumors were treated by means of stereotactic body radiation therapy. Dogs were anesthetized, and neuromuscular blockade was achieved with atracurium or vecuronium. A circle rebreathing system with 15 m (50 feet) of anesthetic tubing coursing through the vault wall was used to connect the patient to the anesthesia machine, which was located in the control room...
January 15, 2017: Journal of the American Veterinary Medical Association
https://www.readbyqxmd.com/read/28057073/a-comparison-of-emergency-airway-management-between-neuromuscular-blockades-alone-and-rapid-sequence-intubation-an-analysis-of-multicenter-prospective-study
#20
MULTICENTER STUDY
Nobuhiro Sato, Yusuke Hagiwara, Hiroko Watase, Kohei Hasegawa
BACKGROUND: Although airway management with neuromuscular blockade (NMB) alone is discouraged in the emergency department (ED), our previous study demonstrated that many patients were intubated using NMBs alone without sedatives. To refute this practice, we sought to compare the intubation success and adverse event rates between NMBs only and rapid sequence intubation (RSI). METHODS: This is a secondary analysis of the data from a prospective observational study of ED patients in 13 hospitals who underwent emergency airway management from April 2010 to August 2012...
January 3, 2017: BMC Research Notes
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