WERTHER BRUNOW DE CARVALHO
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Pediatria, Faculdade de Medicina - Docente
LIM/36 - Laboratório de Pediatria Clínica, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/36 - Laboratório de Pediatria Clínica, Hospital das Clínicas, Faculdade de Medicina - Líder
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bookPart Prefácio à 2ª edição(2020) CARVALHO, Werther Brunow debookPart Acidente vascular encefálico(2022) CARVALHO, Werther Brunow de; MEKITARIAN FILHO, EduardobookPart Urgências em neonatologia(2023) CARVALHO, Werther Brunow de; FORTINI, Alexandre SorianobookPart Manejo das crianças com COVID-19 grave na unidade de terapia intensiva(2021) CARVALHO, Werther Brunow de; FERRANTI, Juliana Ferreira; RODRIGUEZ, Isadora SouzabookPart Síndrome do desconforto respiratório agudo(2022) FIORETTO, José Roberto; CARVALHO, Werther Brunow de- Neuromuscular blockade(2014) SILVA, P. S. L. Da; NETO, H. M.; CARVALHO, W. B. deSince the introduction of the neuromuscular blocking agents (NMBAs) in anesthesia in 1942, a marked evolution has occurred in these drugs. Currently, there are many recognized indications to starting treatment with a NMBA in critically ill children. These may be categorized as short-term, to facilitate procedures, or long-term (sustained neuromuscular blockade), as therapeutic interventions. Atracurium or vecuronium administered by continuous infusion are the choice for the majority of PICU children requiring neuromuscular blockade, however, intermittent doses of pancuronium may be considered as well. Neuromuscular blockade complications can be classified as short-term (accidental extubation, disconnection of the mechanical ventilator), medium-term (edema, venous thrombosis) and long-term (prolonged paralysis, muscle atrophy). Monitoring the neuromuscular blockade level (clinical examination and peripheral nerve stimulation) is recommended and allows the use of lower doses of NMBAs, which may minimize these side effects. Train-offour is the more commonly used method and involves electrical stimulation of a peripheral motor nerve with four sequential stimuli over a two second period and observation of the responses of a muscle innervated by the stimulated nerve. Adequate neuromuscular blockade reversal is essential for restoring and maintaining laryngeal reflexes, respiratory effort and motor function. Recovery may be obtained by using agents that reverse the action of NMBAs, such as anticholinesterase drugs (neostigmine, edrophonium and pyridostigmine) or cyclodextrins (sugammadex). © Springer-Verlag London 2014.
bookPart Prefácio(2020) CARVALHO, Werther Brunow debookPart Avaliação laboratorial da criança com doença grave(2023) CARVALHO, Werther Brunow de; DELGADO, Artur FigueiredobookPart Manejo das crianças com COVID-19 grave na UTI(2023) FERRANTI, Juliana Ferreira; RODRIGUEZ, Isadora Souza; GOES, Patrícia; CARVALHO, Werther Brunow de