Yogun Bakimda Noromuskuler Bloker Ilaclarin Guncel Kullanimi/Current Use of Neuromuscular Blocking Agents in Intensive Care Units

Citation metadata

Authors: Sema Turan and Aysegül Özgök
Date: Aug. 2019
From: Turkish Journal of Anaesthesiology and Reanimation(Vol. 47, Issue 4)
Publisher: AVES
Document Type: Article
Length: 5,204 words

Main content

Abstract :

Nöromüsküler bloker ilaçlar, yogun bakim ünitelerinde; mekanik ventilatör destegi alan hastalarda, hasta ventilatör uyumsuzlugunu ortadan kaldirmak, intraabdominal basinci azaltip, gögüs duvari kompliyansini arttirarak gaz degisimini kolaylastirmak, akcigerlerde barotravma riskini azaltmak, titremeyi önleyerek kaslarin oksijen tüketimine katkisini azaltmak, havayolu uyarisina bagli intrakraniyal basinç artisini sinirlamak gibi amaçlarla kullanilabilir. Akut Respiratuar Distress Sendromu (ARDS), Status Astmatikus, artmis intrakraniyal basinç, ventriküler fibrilasyona bagli kardiyak arrest sonrasi teropatik hipotermi uygulamalari, bu amaçlarla nöromusküler bloker infüzyonunun kullanilabilecegi bazi klinik alanlardir. Yogun bakimda edinilmis güçsüzlük, epileptik nöbetlerin maskelenmesi, yogun bakim ve hastanede kalis sürelerinin uzayabilmesi gibi yan etkiler göz önünde bulunduruldugunda; uygun endikasyon ve kullanim pratigi önem kazanmaktadir. Bu yazinin temel amaci; yetiskin yogun bakim ünitelerindeki nöromüsküler bloker kullanim pratigini özetlemenin yaninda, bu ilaçlarin kardiyopulmoner resüsitasyon sonrasi terapötik hipotermide titremenin önlenmesi ve erken ARDS döneminde oksijenasyonun iyilestirilmesi gibi yogun bakimdaki güncel kullanim alanlari konusundaki bilgilerin derlenmesidir. Anahtar Kelimeler: Kas gevsetici, mekanik ventilasyon, yogun bakim Neuromuscular blocking agents can be used for purposes such as eliminating ventilator-patient dyssynchrony, facilitating gas exchange by reducing intra-abdominal pressure and improving chest wall compliance, reducing risk of lung barotrauma, decreasing contribution of muscles to oxygen consumption by preventing shivering and limiting elevations in intracranial pressure caused by airway stimulation in patients supported with mechanical ventilation in intensive care units. Adult Respiratory Distress Syndrome (ARDS), status asthmaticus, increased intracranial pressure and therapeutic hypothermia following ventricular fibrillation--associated cardiac arrest are some of clinical conditions that can be sustained by neuromuscular blockade. Appropriate indication and clinical practice have gained importance considering side effects such as ICU-acquired weakness, masking seizure activity and longer durations of hospital and ICU stays. We mainly aimed to review the current literature regarding neuromuscular blockade in up-to-date clinical conditions such as improving oxygenation in early ARDS and preventing shivering in the therapeutic hypothermia along with summarising the clinical practice in adult ICU in this report. Keywords: Intensive care unit, mechanical ventilation, neuromuscular blocking agents

Source Citation

Source Citation
Turan, Sema, and Aysegül Özgök. "Yogun Bakimda Noromuskuler Bloker Ilaclarin Guncel Kullanimi/Current Use of Neuromuscular Blocking Agents in Intensive Care Units." Turkish Journal of Anaesthesiology and Reanimation, vol. 47, no. 4, 2019, p. 273+. Accessed 4 Dec. 2020.
  

Gale Document Number: GALE|A595026651