The Science Journal of the American Association for Respiratory Care

1996 OPEN FORUM Abstracts

All Patients Requiring High Levels of Ventilatory Support Should Be Heavily Sedated or Neuromuscularly Blocked

Robert S. Campbell, RRT Wednesday, November 6, 1996

Paralysis and heavy sedation of mechanically ventilated patients is frought with numerous physiologic derangements and potential complications. Paralysis retards mucociliary clearance, prevents coughing, and results in retained secretions. Recent work also suggests permanent damage to the neuromuscular junction may result from prolonged use of certain neuromuscular blocking agents. This may prolong mechanical ventilation.

Paralysis and heavy sedation also may have negative effects on pulmonary function as a result of the need for full ventilatory support. Spontaneous breathing is associated with a lower deadspace to tidal volume ratio and improved ventilation/perfusion matching as compared to mandatory ventilation. Hemodynamic compromise may also result from paralysis and heavy sedation.

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