The pharmacokinetics and pharmacodynamics of cisatracurium in critically ill patients with severe sepsis

Liu, Xin, Kruger, Peter S., Weiss, Michael and Roberts, Michael S. (2012) The pharmacokinetics and pharmacodynamics of cisatracurium in critically ill patients with severe sepsis. British Journal of Clinical Pharmacology, 73 5: 741-749. doi:10.1111/j.1365-2125.2011.04149.x


Author Liu, Xin
Kruger, Peter S.
Weiss, Michael
Roberts, Michael S.
Title The pharmacokinetics and pharmacodynamics of cisatracurium in critically ill patients with severe sepsis
Journal name British Journal of Clinical Pharmacology   Check publisher's open access policy
ISSN 0306-5251
1365-2125
Publication date 2012-05
Year available 2011
Sub-type Article (original research)
DOI 10.1111/j.1365-2125.2011.04149.x
Volume 73
Issue 5
Start page 741
End page 749
Total pages 9
Place of publication Oxford, United Kingdom
Publisher Wiley-Blackwell Publishing
Collection year 2012
Language eng
Formatted abstract
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 8 h after a single bolus dose of cisatracurium 0.1 mg kg−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 ± 71 ml kg−1 and plasma clearance was 5.2 ± 1.8 ml min−1 kg−1 in these patients with greater inter-patient variability compared with other populations. The time to maximum block (8.3 ± 2.9 min) and delay time of transferring from central to effect compartment (17.2 min) 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 ± 58 ng ml−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.
Keyword Cisatracurium
Intensive care
Pharmacodynamics
Pharmacokinetics
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes © 2011 The Authors. British Journal of Clinical Pharmacology. © 2011 The British Pharmacological Society.

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2012 Collection
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