Stevens et al listed criteria for the diagnosis of prolonged neuromuscular blockade in a patient with intensive care unit-acquired weakness. The authors are from the Johns Hopkins University, Uniformed Services University of Health Sciences, Ohio State University, Centre Hospitalier de Poissy-Saint-Germain and University of Versailles Saint-Quentin en Yvelines Garches.


Diagnostic criteria for prolonged neuromuscular blockade - all of the following:

(1) The patients meets the criteria for ICUAW and has cranial nerve involvement.

(2) The patient has a history of exposure to a neuromuscular blocking agent within the past 10 days.

(3) Compound muscle action potential amplitudes are absent or decreased.

(4) 2 to 3 Hz repetitive nerve stimulation causes a > 10% decrimental response.

(5) Recovery of motor function occurs within 14 days.



• Cranial nerve involvement may include ptosis, ophthalmoparesis and/or facial weakness.

• The neuromuscular blocking agent may have been administered as an infusion or over multiple doses.


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