Aim To characterize the pharmacokinetics (PK) and pharmacodynamics (PD) of cisatracurium in critically ill patients with severe sepsis. Methods: Blood samples were collected before and over 8h after a single bolus dose of cisatracurium 0.1mgkg -1. Neuromuscular block was assessed by accelerometric peripheral nerve stimulation (TOF Watch). Plasma concentration and neuromuscular block data were fitted using population analysis. Results: Steady-state volume of distribution was determined to be 111±71mlkg -1 and plasma clearance was 5.2±1.8mlmin -1kg -1 in these patients with greater inter-patient variability compared with other populations. The time to maximum block (8.3±2.9min) and delay time of transferring from central to effect compartment (17.2min) was much longer, while the maximum block (95.0±6.3%) was less compared with those in other patient populations. The effect compartment concentration resulting in 50% of maximum effect (128±58ngml -1) was larger than previously described. Conclusions: This study suggests that standard dosing of cisatracurium in patients with severe sepsis results in a slower patient response with a reduced effect. Use of a larger dose may overcome this reduced delayed response. © 2011 The Authors. British Journal of Clinical Pharmacology © 2011 The British Pharmacological Society.
CITATION STYLE
Liu, X., Kruger, P. S., Weiss, M., & Roberts, M. S. (2012). The pharmacokinetics and pharmacodynamics of cisatracurium in critically ill patients with severe sepsis. British Journal of Clinical Pharmacology, 73(5), 741–749. https://doi.org/10.1111/j.1365-2125.2011.04149.x
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