SCCM Resource Library-April Journal Club: Critical Care Medicine (2020)

Video Transcription

Video Summary

In this Journal Club Critical Care Medicine webcast, the presenters discuss a pro-con debate on the use of rescue neuromuscular blockade in acute respiratory distress syndrome (ARDS). Ivan Koh presents the viewpoint that rescue neuromuscular blockade should be administered in a flat dose, while Alexander H. Flannery presents the counter viewpoint that it should not be flat dosed. Koh explains the benefits of neuromuscular blockade in ARDS, the different classes of neuromuscular blockers, and the dosing used in recent trials. He argues that flat dosing is simpler and less prone to dosing errors. Flannery, on the other hand, argues that flat dosing is excessive and more drug than needed, with potential negative effects on costs, fluid volume, and patient outcomes. He suggests using a titration approach based on clinical parameters such as ventilator synchronization. They both present evidence from studies and discuss the challenges of monitoring paralysis and assessing ICU-acquired weakness. They conclude that flat dosing should not be the standard approach and that titration based on individual patient needs is preferable. They also discuss the impact of the COVID-19 pandemic on neuromuscular blockade use and highlight the need for ongoing research on this topic.

Asset Subtitle

Pharmacology, Pulmonary, 2020

Asset Caption

"The Journal Club: Critical Care Medicine webcast series focuses on articles of interest from Critical Care Medicine.

This series is held on the fourth Thursday of each month and features in-depth presentations and lively discussion by the authors.

Follow the conversation at #CritCareMed."

Meta Tag

Content Type Webcast

Knowledge Area Pharmacology

Knowledge Area Pulmonary

Knowledge Level Intermediate

Knowledge Level Advanced

Membership Level Select

Membership Level Professional

Membership Level Associate

Tag Pharmacology

Tag Acute Respiratory Distress Syndrome ARDS

Year 2020

Keywords

rescue neuromuscular blockade

acute respiratory distress syndrome

flat dosing

neuromuscular blockers

dosing errors

ventilator synchronization

ICU-acquired weakness

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