Prolonged paralysis in intensive care unit patients after the use of neuromuscular blocking agents

Controlled studies assessing the appropriate drug, administration method, use of drug in end-organ dysfunction, and monitoring techniques are unavailable. From the available case reports, length of neuromuscular blockade has been associated with end-organ dysfunction, concomitant drug use, severity of the underlying illness, length of therapy, monitoring techniques used, and perhaps method of drug administration. Steroidally based neuromuscular blocking agents may be particularly hazardous in patients receiving systemic corticosteroids. It is premature to determine the safety of one particular neuromuscular blocking drug in relation to another. Further studies are needed to optimize the use and safety of neuromuscular blocking agents in intensive care unit patients.