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Author Torbic, Heather ♦ Bauer, Seth R. ♦ Personett, Heather A. ♦ Dzierba, Amy L. ♦ Stollings, Joanna L. ♦ Ryder, Lindsay P. ♦ Daniels, Craig E. ♦ Caples, Sean M. ♦ Frazee, Erin N.
Source World Health Organization (WHO)-Global Index Medicus
Content type Text
Publisher Elsevier
File Format HTM / HTML
Language English
Difficulty Level Medium
Subject Domain (in DDC) Technology ♦ Medicine & health ♦ Diseases
Subject Keyword Discipline Critical Care
Abstract PURPOSE: Neuromuscular blocking agents (NMBAs) are frequently used in patients with acute respiratory distress syndrome (ARDS). The purpose of this survey is to describe providers' knowledge and perceived efficacy and safety of NMBAs in patients with ARDS. MATERIALS AND METHODS: We performed a prospective, multicenter survey of medical intensive care unit intensivists, fellows, nurse practitioners (NPs), physician's assistants (PAs), and pharmacists at 5 tertiary care centers between July 2012 and May 2013. RESULTS: A total of 335 surveys were sent to providers, with a 47% response rate. Ninety-eight percent of providers correctly identified that NMBAs lack anxiolytic and analgesic properties. The effect of end-organ damage on NMBA clearance was less commonly identified by NPs/PAs for both hepatic (P=.0077) and renal (P=.0272) dysfunction compared with physicians. More NP/PAs identified the association of consciousness with the use of NMBAs than physicians (P=.047). Forty-two percent of prescribers reported always or frequently using continuous-infusion NMBAs in patients with severe ARDS, with 89% initiating NMBAs because of ventilator dyssynchrony. Prescribers perceived continuous NMBAs to be more effective than inhaled prostaglandins (74% vs 56%) in severe ARDS but less safe (45% vs 84%). Train of 4 was identified by 54% of prescribers as their primary method for titration. CONCLUSION: Providers are knowledgeable about NMBAs, but educational opportunities exist. Perceptions about the efficacy and safety of NMBAs varied among prescribers, and inconsistencies existed in the prioritization of management strategies for ARDS.
Description Author Affiliation: Torbic H ( Department of Pharmacy, Cleveland Clinic, 9500 Euclid Ave, Hb-105, Cleveland, OH 44195. Electronic address: torbich@ccf.org.); Bauer SR ( Department of Pharmacy, Cleveland Clinic, 9500 Euclid Ave, Hb-105, Cleveland, OH 44195.); Personett HA ( Department of Pharmacy, Mayo Clinic, 200 1st St SW, Rochester, MN 55901.); Dzierba AL ( Department of Pharmacy, New York Presbyterian Hospital, 612 W 168th St, New York, NY 10032.); Stollings JL ( Department of Pharmaceutical Services, Vanderbilt University Medical Center, 1211 Medical Center Dr, Nashville, TN 37232.); Ryder LP ( Department of Pharmacy, The Ohio State University Wexner Medical Center, 410 W 10th Ave, Columbus, OH 43210.); Daniels CE ( Division of Pulmonary and Critical Care Medicine, Mayo Clinic, 200 1st St SW, Rochester, MN 55901.); Caples SM ( Division of Pulmonary and Critical Care Medicine, Mayo Clinic, 200 1st St SW, Rochester, MN 55901.); Frazee EN ( Department of Pharmacy, Mayo Clinic, 200 1st St SW, Rochester, MN 55901.)
ISSN 08839441
Educational Role Student ♦ Teacher
Age Range above 22 year
Educational Use Reading ♦ Research ♦ Self Learning
Interactivity Type Expositive
Education Level UG and PG
Learning Resource Type Article
Publisher Date 2017-04-01
Publisher Place United States
e-ISSN 15578615
Journal Journal of Critical Care
Volume Number 38


Source: WHO-Global Index Medicus