• Medicina intensiva · Mar 2015

    Observational Study

    Contraindications to succinylcholine in the intensive care unit. A prevalence study.

    • T Muñoz-Martínez, I Garrido-Santos, R Arévalo-Cerón, L Rojas-Viguera, T Cantera-Fernández, R Pérez-González, and E Díaz-Garmendia.
    • Servicio de Medicina Intensiva, Hospital Universitario de Cruces, Baracaldo, Vizcaya, España. Electronic address: tomas.munozmartinez@osakidetza.net.
    • Med Intensiva. 2015 Mar 1; 39 (2): 90-6.

    ObjectiveTo determine the prevalence of contraindications to succinylcholine in patients admitted to the ICU.DesignAn observational study was carried out, describing the frequency of succinylcholine contraindication by stays, and associating the contraindications to population variables.SettingThe adult general ICU of a reference hospital.PatientsClinical-surgical critically ill patients. Thirty consecutive days were analyzed.InterventionsNone.VariablesPopulation variables: age, sex, APACHE II and SOFA scores, illness, days of hospitalization, mechanical ventilation and renal replacement therapy.Contraindicationshyperkalemia, bedridden patients, rhabdomyolysis, muscle trauma, burns, infusion of neuromuscular blocking agents, acute renal failure, chronic renal failure, intraocular hypertension, intracranial hypertension, statin use, malignant hyperthermia, neuromuscular disease, spinal cord sectioning, bradycardia < 50 bpm, succinylcholine allergy, and pseudo-cholinesterase deficiency.ResultsA total of 102 patients were admitted, aged 60 ± 16 years (56.9% males), with the generation of 657 stays. Main diseases: elective heart surgery (33%), respiratory failure (22%) and sepsis (14%). We documented 466 stays (70.9%) with contraindications, particularly bedridden patients (n=140), neuromuscular blocking agents (n=101), acute renal failure (n=126), statin use (n=167), neuromuscular disease (n=159) and bradycardia (n=76). We recorded 74 stays (11.3%) at high risk of complications, secondary to hyperkalemic risk associated to receptor dysregulation. A high risk of complications was associated to advanced age, prolonged hospitalization, prolonged length of stay in the ICU, higher APACHE II and SOFA scores, mechanical ventilation and renal replacement therapy.ConclusionGiven the high prevalence of contraindications to succinylcholine observed, we discourage its use in patients admitted to the ICU.Copyright © 2014 Elsevier España, S.L.U. and SEMICYUC. All rights reserved.

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