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Curares en réanimation: indications, pharmacologie, monitorage

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Analgésie et sédation en réanimation

Part of the book series: Le point sur ... ((POINT))

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L’utilisation des curares en réanimation s’est restreinte au cours des dernières années, en raison notamment des problèmes liés aux phénomènes d’accumulation (curarisation prolongée) et de leur rôle supposé dans le développement des atteintes neuromusculaires acquises en réanimation. Mais leur intérêt est relancé par des travaux récents concernant la curarisation précoce des patients en SDRA et par la mise à disposition de composés plus maniables dans ce contexte comme le cis-atracurium. Quel que soit le curare utilisé, leur administration ne peut se concevoir qu’après avoir débuté une sédation et/ou une analgésie efficace. L’utilisation de curarisations ponctuelles d’appoint met souvent en évidence les limites des stratégies de sédation conventionnelles. Enfin, le monitorage instrumental de la curarisation est utile pour adapter les doses, détecter l’apparition éventuelle d’une tachyphylaxie et diagnostiquer une curarisation prolongée.

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Authors
  1. F. Cook
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  2. B. Plaud
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© 2010 Springer-Verlag France, Paris

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Cook, F., Plaud, B. (2010). Curares en réanimation: indications, pharmacologie, monitorage. In: Analgésie et sédation en réanimation. Le point sur .... Springer, Paris. https://doi.org/10.1007/978-2-287-99029-8_8

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  • DOI: https://doi.org/10.1007/978-2-287-99029-8_8

  • Publisher Name: Springer, Paris

  • Print ISBN: 978-2-287-99028-1

  • Online ISBN: 978-2-287-99029-8

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