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Philips Intellivue NMT module: precision and performance improvements to meet the clinical requirements of neuromuscular block management

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Dubois, Virginie [UCL] Fostier, Guillaume [UNamur] Dutrieux, Marie [UCL] Jamart, Jacques [UCL] Collet, Stéphanie [UCL] De Dorlodot, Clotilde [UCL] Eloy, Philippe [UCL] Dubois, Philippe E [UCL]

offour (TOF) ratio during neuromuscular block (NMB) recovery. This study evaluated the precision and performance of the Philips Intellivue NMT module (NMT) before (part 1) and after (part 2) several technical upgrades (i.e., firmware upgrade, new cable, and hand adapter) that were recently available. Two cohorts of 30 patients who were scheduled to undergo rhino/ septoplasty under general anesthesia were included in the study. TOF ratios were recorded simultaneously every 15 s on both hands with the NMT and a TOF-Watch SX installed inside a SL TOF-Tube (TWX). Before rocuronium was administered and once final responses were stabilized, the average of the four successive measurements that determined the baselines and repeatability coefficients were compared using a z test. Simultaneous measurements were recorded at different NMB stages: onset, depth of NMB after intubation, when TWX recovered TOF count 2, TOF ratios 0.5 and 0.9, and when NMT recovered TOF ratio 0.9. The results were compared using a Student t test; p < 0.05 was considered significant. The NMT repeatability coefficients obtained in part 1 were significantly higher than with the TWX, they were significantly lower in part 2. Initially, the NMT significantly overestimated NMB recovery at every stage. Conversely, in the second part of the study, no difference reached statistical significance. With the recent upgrades and the new hand adapter, the NMT provided similar results compared with the TWX, Their implementation should be recommended in clinical practice.

Document type Article de périodique (Journal article) – Article de recherche
Access type Accès libre
Publication date 2020
Language Anglais
Journal information "Journal of Clinical Monitoring and Computing" - Vol. 34, p. 111-116 (2020)
Peer reviewed yes
Publisher Springer ((Netherlands) Amsterdam)
issn 1387-1307
e-issn 1573-2614
Publication status Publié
Affiliations UCL - SSS/IREC/LUNS - Pôle pneumologie, ORL (airways) et dermatologie (skin)
UCL - SSS/IREC/MEDA - Pôle de médecine aiguë
UCL - SSS/IREC/MONT - Pôle Mont Godinne
UCL - (MGD) Service d'anesthésiologie
UCL - (MGD) Unité de support scientifique
UCL - (MGD) Service d'oto-rhino-laryngologie
Keywords Anesthesiology and Pain Medicine ; Health Informatics ; Critical Care and Intensive Care Medicine
Links
  1. Fuchs-Buder T., Claudius C., Skovgaard L. T., Eriksson L. I., Mirakhur R. K., Viby-Mogensen J., Good clinical research practice in pharmacodynamic studies of neuromuscular blocking agents II: the Stockholm revision, 10.1111/j.1399-6576.2007.01352.x
  2. Naguib Mohamed, Brull Sorin J., Kopman Aaron F., Hunter Jennifer M., Fülesdi Béla, Arkes Hal R., Elstein Arthur, Todd Michael M., Johnson Ken B., Consensus Statement on Perioperative Use of Neuromuscular Monitoring : , 10.1213/ane.0000000000002670
  3. Brull Sorin J., Murphy Glenn S., Residual Neuromuscular Block : Lessons Unlearned. Part II, 10.1213/ane.0b013e3181da8312
  4. Plaud Benoît, Debaene Bertrand, Donati François, Marty Jean, Residual Paralysis after Emergence from Anesthesia : , 10.1097/aln.0b013e3181cded07
  5. Eikermann Matthias, Vogt Florian M., Herbstreit Frank, Vahid-Dastgerdi Mehdi, Zenge Michael O., Ochterbeck Christof, de Greiff Armin, Peters Jürgen, The Predisposition to Inspiratory Upper Airway Collapse during Partial Neuromuscular Blockade, 10.1164/rccm.200512-1862oc
  6. Murphy Glenn S., Szokol Joseph W., Marymont Jesse H., Greenberg Steven B., Avram Michael J., Vender Jeffery S., Nisman Margarita, Intraoperative Acceleromyographic Monitoring Reduces the Risk of Residual Neuromuscular Blockade and Adverse Respiratory Events in the Postanesthesia Care Unit : , 10.1097/aln.0b013e318182af3b
  7. Murphy Glenn S., Szokol Joseph W., Avram Michael J., Greenberg Steven B., Shear Torin, Vender Jeffery S., Gray Jayla, Landry Elizabeth, Postoperative Residual Neuromuscular Blockade Is Associated with Impaired Clinical Recovery : , 10.1213/ane.0b013e3182742e75
  8. Mogensen J. Viby, Jensen E., Werner M., Nielsen H. Kirkegaard, Measurement of acceleration: a new method of monitoring neuromuscular function, 10.1111/j.1399-6576.1988.tb02686.x
  9. Claudius Casper, Viby-Mogensen Jørgen, Acceleromyography for Use in Scientific and Clinical Practice : A Systematic Review of the Evidence, 10.1097/aln.0b013e318173f62f
  10. Viby-Mogensen Jørgen, Neuromuscular monitoring : , 10.1097/00001503-200112000-00010
  11. SCHREIBER J.-U., MUCHA E., FUCHS-BUDER T., Acceleromyography to assess neuromuscular recovery: is calibration before measurement mandatory? : Residual paralysis and acceleromyography, 10.1111/j.1399-6576.2010.02378.x
  12. Suzuki T, Fukano N, Kitajima O, Saeki S, Ogawa S, Normalization of acceleromyographic train-of-four ratio by baseline value for detecting residual neuromuscular block, 10.1093/bja/aei273
  13. Stouffs Alexandre, Ibsen Arni, Jamart Jacques, Dubois Virginie, Dubois Philippe E., Philips Intellivue NMT module: variability of initial measurements, 10.1007/s10877-017-0079-y
  14. Dubois Philippe E., De Bel Maxime, Jamart Jacques, Mitchell John, Gourdin Maximilien, Dransart Christophe, d’Hollander Alain, Performance of acceleromyography with a short and light TOF-tube compared with mechanomyography : A clinical comparison, 10.1097/eja.0b013e3283645691
  15. Faul Franz, Erdfelder Edgar, Lang Albert-Georg, Buchner Axel, G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences, 10.3758/bf03193146
  16. Mencke Thomas, Echternach Mathias, Kleinschmidt Stefan, Lux Philip, Barth Volker, Plinkert Peter K., Fuchs-Buder Thomas, Laryngeal Morbidity and Quality of Tracheal Intubation : A Randomized Controlled Trial, 10.1097/00000542-200305000-00005
  17. Bruintjes M.H., van Helden E.V., Braat A.E., Dahan A, Scheffer G.J., van Laarhoven C.J., Warlé M.C., Deep neuromuscular block to optimize surgical space conditions during laparoscopic surgery: a systematic review and meta-analysis, 10.1093/bja/aex116
  18. CLAUDIUS C., SKOVGAARD L. T., VIBY-MOGENSEN J., Acceleromyography and mechanomyography for establishing potency of neuromuscular blocking agents: a randomized-controlled trial, 10.1111/j.1399-6576.2008.01866.x
  19. Claudius Casper, Calibration of the neuromuscular monitor: Is it necessary?, 10.1007/s12630-015-0535-4
  20. Kopman A. F., Chin W., Cyriac J., Acceleromyography vs. electromyography: an ipsilateral comparison of the indirectly evoked neuromuscular response to train-of-four stimulation : Acceleromyography vs. electromyography, 10.1111/j.1399-6576.2005.00643.x
  21. Brull SJ, Silverman DS. Real time versus slow motion train-of-four monitoring: a theory to explain the inaccuracy of visual assessment. Anesth Analg. 1995;80:548–51.
  22. Kopman Aaron F., Measurement and monitoring of neuromuscular blockade : , 10.1097/00001503-200208000-00002
  23. Claudius Casper, Skovgaard Lene Theil, Viby-Mogensen Jørgen, Is the Performance of Acceleromyography Improved with Preload and Normalization? : A Comparison with Mechanomyography, 10.1097/aln.0b013e3181a4f239
  24. Capron Florent, Alla Francois, Hottier Claire, Meistelman Claude, Fuchs-Buder Thomas, Can Acceleromyography Detect Low Levels of Residual Paralysis? : A Probability Approach to Detect a Mechanomyographic Train-of-four Ratio of 0.9, 10.1097/00000542-200405000-00013
  25. Claudius C, Skovgaard L.T., Viby-Mogensen J, Arm-to-arm variation when evaluating neuromuscular block: an analysis of the precision and the bias and agreement between arms when using mechanomyography or acceleromyography, 10.1093/bja/aeq162
Bibliographic reference Dubois, Virginie ; Fostier, Guillaume ; Dutrieux, Marie ; Jamart, Jacques ; Collet, Stéphanie ; et. al. Philips Intellivue NMT module: precision and performance improvements to meet the clinical requirements of neuromuscular block management. In: Journal of Clinical Monitoring and Computing, Vol. 34, p. 111-116 (2020)
Permanent URL http://hdl.handle.net/2078.1/214345