Critical Care PRN Focus Session — An Analysis of Paralysis: Neuromuscular Blocking Agents in the Critical Care Setting

Neuromuscular blocking agents (NMBAs) have many clinical uses in the critical care setting including rapid sequence intubation (RSI), acute respiratory distress syndrome (ARDS), and various neurologic conditions. Data for the usage, patient populations with which to apply the data, and execution of using these agents requires an intimate understanding of the strengths and limitations of the literature to promote safe and effective therapy. This session will explore some of the clinical controversies surrounding the application of NMBAs to various critically ill patients. The session will be 90 minutes broken down into 3 sections and include interactive patient cases as the backdrop for each subsection. The first section will explore RSI, investigate the evidence of rocuronium versus succinylcholine, and the considerations surrounding early continuous sedation after RSI. The second section will explore the mechanism of usage of NMBA, specifically investigating continuous versus intermittent NMBA and goals of therapeutic “monitoring” for NMBAs (e.g., train-of-four versus ventilator targets versus bispectral index monitoring). The final section will explore the use of NMBAs without sedation for various diagnostic and therapeutic applications (e.g., somatosensory evoked potentials (SSEPs) testing) and investigate the use of sugammadex for NMBA reversal in non-operating room settings.

Moderator: Scott T. Benken, Pharm.D., MHPE, FCCP, FCCM, BCCCP Clinical Associate Professor | Pharmacy Practice | Retzky College of Pharmacy Clinical Pharmacist | Medical Intensive Care Unit | University of Illinois Health PGY2 Critical Care Pharmacy Residency - Program Director   View Biography

An Analysis of Paralysis: Focus on NMBA in RSI 10:15 a.m. to 10:45 a.m. Speaker: Megan A. Rech, Pharm.D., Masters in Research, FCCP, FCCM, BCCCP Research Health Scientist | Clinical Pharmacist Specialist Center of Innovation for Complex Chronic Healthcare Edward Hines Jr VA Hospital   View Biography

An Analysis of Paralysis: Focus on NMBA Administration and Monitoring 10:45 a.m. to 11:15 a.m. Speaker: Julie DiBridge Clarkson, Pharm.D., BCCCP, BCCP Assistant Professor, University of Pittsburgh School of Pharmacy Clinical Pharmacist, Advanced Heart Failure and Pulmonary Hypertension, UPMC Presbyterian Hospital Pittsburgh, PA   View Biography

An Analysis of Paralysis: Focus on NMBA and Awake Paralysis and Reversal Strategies 11:15 a.m. to 11:45 a.m. Speaker: Eric Johnson, Pharm.D., MBA, BCCCP Perioperative Critical Care Pharmacist University of Kentucky HealthCare Associate Adjunct Professor | UK Colleges of Pharmacy and Medicine Department of Pharmacy Practice and Science Department of Anesthesiology, Perioperative, Critical Care & Pain Medicine Lexington, Kentucky   View Biography