ERS Respiratory Channel

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Abstract

Objective

For RSI, Nondepolarizing NMB has gradually replaced succinylcholine. However, its long-duration paralysis effect may prolong the vulnerable status of critically ill patients after intubation.

Does the incidence of post-intubation cardiac arrest differ between depolarizing and nondepolarizing NMBs?

Methods

A retrospective analysis of acute respiratory failure patients who received RSI in a university hospital in the past 12 years.

Results

Demographic data:

Outcomes:

	Succinylcholine	Nondepolarizing NMBs	P value
ED cases, N	228	1929
Status of leaving ER			0.33
Expired	4 (1.8%)	55 (2.9%)
ICU admission	224 (98.2%)	1874 (97.1%)
Hospitalized cases, N	2714	849
CPR within 6 hours after RSI	185 (6.8%)	43 (5.1%)	0.069
All cases, N	2942	2778
Combined cardiac arrest events	189 (6.4%)	98 (3.5%)	<0.05

Conclusion

After RSI, the mortality at ED and the incidence of CPR events within 6 hours during hospitalized patients are similar between different choices of NMBs. The combined data show that succinylcholine is associated with higher cardiac arrest events.

Abstract

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