Abstract | AIM: METHODS: Blood samples were collected before and over 8 h after a single bolus dose of cisatracurium 0.1 mg kg(-1) . Neuromuscular block was assessed by accelerometric peripheral nerve stimulation (TOF Watch). Plasma concentration and neuromuscular block data were fitted using population analysis. RESULTS: Steady-state volume of distribution was determined to be 111 ± 71 ml kg(-1) and plasma clearance was 5.2 ± 1.8 ml min(-1) kg(-1) in these patients with greater inter-patient variability compared with other populations. The time to maximum block (8.3 ± 2.9 min) and delay time of transferring from central to effect compartment (17.2 min) was much longer, while the maximum block (95.0 ± 6.3%) was less compared with those in other patient populations. The effect compartment concentration resulting in 50% of maximum effect (128 ± 58 ng ml(-1)) was larger than previously described. CONCLUSIONS: This study suggests that standard dosing of cisatracurium in patients with severe sepsis results in a slower patient response with a reduced effect. Use of a larger dose may overcome this reduced delayed response.
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Authors | Xin Liu, Peter S Kruger, Michael Weiss, Michael S Roberts |
Journal | British journal of clinical pharmacology
(Br J Clin Pharmacol)
Vol. 73
Issue 5
Pg. 741-9
(May 2012)
ISSN: 1365-2125 [Electronic] England |
PMID | 22114771
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Copyright | © 2011 The Authors. British Journal of Clinical Pharmacology © 2011 The British Pharmacological Society. |
Chemical References |
- Neuromuscular Blocking Agents
- Atracurium
- cisatracurium
|
Topics |
- Adult
- Aged
- Atracurium
(analogs & derivatives, pharmacokinetics, pharmacology)
- Critical Illness
- Dose-Response Relationship, Drug
- Drug Resistance
- Female
- Humans
- Male
- Middle Aged
- Models, Biological
- Neuromuscular Blocking Agents
(pharmacokinetics, pharmacology)
- Sepsis
(drug therapy, metabolism)
- Severity of Illness Index
- Time Factors
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