Retrospective pharmacoeconomic evaluation of dosing vecuronium by peripheral nerve stimulation versus standard clinical assessment in critically ill patients.

摘要: Adjusting the dosage of vecuronium by peripheral nerve stimulation versus standard clinical dosing in critically ill patients reduces drug requirements to maintain a desired depth paralysis and, on average, produces faster recovery neuromuscular function. We retrospectively analyzed health and economic outcomes using train-of-four (TOF) end points blocking agents during continuous infusion medical intensive care unit (ICU). A decision-analytic model was used calculate costs treatment not TOF vecuronium. Data from our trial provided difference functional time. Charges billed Patient Financial Services Department were determine hourly ICU stay for blockade costs:charges ratios estimated sample 20 patients. The cost determined hospital acquisition actual number milligrams given each patient trial. performing one event timing six events performed pharmacists, randomly selecting 60% these mean time/TOF event. impact calculating savings/patient dosed compared with those who had doses individualized assessment. One-way multiway sensitivity analyses assess uncertainty. $286 group $580 group. With assessment 5.8 +/- 1.6 minutes, episode $2.92 total cost/patient $23. At $54/hour time ICU, $34,214 $118,681 costs/patient $459 $1197, respectively, $738. Sensitivity showed be robust. Estimated annual savings $146,103 are projected individualize ICU. Individualizing has both therapeutic advantages. When considering drug, monitoring, 40% that control