지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2012.1
- 수록면
- 140 - 150 (11page)
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초록· 키워드
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Department of Anesthesiology and Pain Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea Critical illness often results in renal dysfunction. Renal disease includes acid base imbalance, electrolyte shift and neuromuscular disturbances in critically ill patients, who are influenced by the pharmacodynamics and pharmacokinetics of muscle relaxants, with kidney dependent metabolism and excretion. In terms of renal dysfunction, not only decreased circulating levels of normal cholinesterase, but also cholinesterase depletion after plasmapheresis and dialysis draw the attention of clinicians, when administering a muscle relaxant to critically ill patients who are compromised with renal function. These patients have a lower clearance of renal excreted drugs, changes of the volume of distribution, water retention, and pH changes that alter the protein bond and degree of ionization of the drugs. Immobilization of the limb and respiratory muscles, leading to muscle atrophy and the up-regulation of nicotinic acetylcholine receptors, associated with critical illness, is observed in many patients hospitalized in the intensive care unit with renal dysfunction. Disease related conditions or iatrogenically induced factors, including sedation, lead to immobilization of skeletal muscles. Aside from systemic inflammation, immobilization is a key contributing factor to the development of critical illness myopathy. Physicians who care for critically ill patients with renal dysfunction should pay attention to the adequate choice of muscle relaxants and their antagonists.
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등록된 정보가 없습니다.
참고문헌 (25)
참고문헌 신청
Berek K / 1996 / Polyneuropathies in critically ill patients: a prospective evaluation / Intensive Care Med 22 : 849 ~ 855
Bittner EA / 2009 / Measurement of muscle strength in the intensive care unit / Crit Care Med 37 (10 Suppl) : S321 ~ S330
Chronic Kidney Disease Prognosis Consortium / 2010 / Association of estimated glomerular filtration rate and albuminuria with all-cause and cardiovascular mortality in gener
Deem S / 2003 / Acquired neuromuscular disorders in the intensive care unit / Am J Respir Crit Care Med 168 : 735 ~ 739
Demirjian S / 2011 / Critical care: estimating renal function in the ICU: even more challenging / Nat Rev Nephrol 7 : 549 ~ 550
Bittner EA / 2009 / Measurement of muscle strength in the intensive care unit / Crit Care Med 37 (10 Suppl) : S321 ~ S330
Chronic Kidney Disease Prognosis Consortium / 2010 / Association of estimated glomerular filtration rate and albuminuria with all-cause and cardiovascular mortality in gener
Deem S / 2003 / Acquired neuromuscular disorders in the intensive care unit / Am J Respir Crit Care Med 168 : 735 ~ 739
Demirjian S / 2011 / Critical care: estimating renal function in the ICU: even more challenging / Nat Rev Nephrol 7 : 549 ~ 550
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