EVALUATION OF VECURONIUM NEUROMUSCULAR BLOCKADE IN PEDIATRIC PATIENTS WITH THERMAL INJURY

Neuromuscular blocking agents (NMBAs) have been widely used to control patients who need to be immobilized for some kind of medical intervention, such as an invasive procedure or synchronism with mechanical ventilation. The purpose of this monograph is to review the pharmacology of the NMBAs, to compare the main differences between the neuromuscular junction in neonates, infants, toddlers and adults, and moreover to discuss their indications in critically ill pediatric patients. Continuous improvement of knowledge about NMBAs pharmacology, adverse effects, and the many other remaining unanswered questions about neuromuscular junction and neuromuscular blockade in children is essential for the correct use of these drugs. Therefore, the indication of these agents in pediatrics is determined with extreme judiciousness. Computorized (Medline 1990-2000) and active search of articles were the mechanisms used in this review.

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Effect of Growth Hormone Adminstration on Cardiac Function in Pediatric Patients with Thermal Injury

Journal of Burn Care & Rehabilitation ◽

10.1097/00004630-200203002-00014 ◽

2002 ◽

Vol 23 ◽

pp. S47

Author(s):

R. P. Mlcak ◽

O. E. Suman ◽

J. Cortiella ◽

D. N. Herndon

Keyword(s):

Growth Hormone ◽

Cardiac Function ◽

Thermal Injury ◽

Pediatric Patients

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Sugammadex: Applications in Pediatric Critical Care

Journal of Pediatric Intensive Care ◽

10.1055/s-0040-1705133 ◽

2020 ◽

Vol 09 (03) ◽

pp. 162-171

Author(s):

Joseph D. Tobias

Keyword(s):

Neuromuscular Blockade ◽

Pediatric Patients ◽

Pediatric Population ◽

Acetylcholinesterase Inhibitor ◽

Pediatric Intensive Care ◽

Acetylcholinesterase Inhibitors ◽

Intensive Care Unit Population ◽

Pharmacologic Agent ◽

Complete Reversal ◽

Prospective Trials

AbstractSugammadex is a novel pharmacologic agent, which reverses neuromuscular blockade with a mechanism that differs from acetylcholinesterase inhibitors such as neostigmine. There is a growing body of literature demonstrating its efficacy in pediatric patients of all ages. Prospective trials have demonstrated a more rapid and more complete reversal of rocuronium-induced neuromuscular blockade than the acetylcholinesterase inhibitor, neostigmine. Unlike the acetylcholinesterase inhibitors, sugammadex effectively reverses intense or complete neuromuscular blockade. It may also be effective in situations where reversal of neuromuscular blockade is problematic including patients with neuromyopathic conditions or when acetylcholinesterase inhibitors are contraindicated. This article reviews the physiology of neuromuscular transmission as well as the published literature, regarding the use of sugammadex in pediatric population including the pediatric intensive care unit population. Clinical applications are reviewed, adverse effects are discussed, and dosing algorithms are presented.

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