ArticleMedicine2020
Bilateral dilated nonreactive pupils secondary to rocuronium infusion in an ARDS patient treated with ECMO therapy: A case report.
Article in Medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 13 citations in OpenAlex.
- Reversible Bilateral Fixed Dilated Pupils in Hypercapnic Respiratory Failure Following Chronic Graft Versus Host Disease: A Case Report and Review of Literature.Clinical case reports · 2025Article
- The Presence of Bilateral Dilated Pupils is Not a Death Sentence in a Stroke Patient: A Case Report.Cureus · 2024Article
- A glimpse into multimodal neuromonitoring in acute liver failure: a case report.Annals of medicine and surgery (2012) · 2024Article
- Dilated fixed pupils and respiratory failure: a rare clinical course of Lambert-Eaton myasthenic syndrome.BMJ neurology open · 2023Article
- Brain injury after cardiac arrest: pathophysiology, treatment, and prognosis.Intensive care medicine · 2021Review
- Fixed dilated pupils in Covid-19 ARDS patients under rocuronium, reversed after discontinuation.Journal of critical care · 2021Article
- Intravenous infusion of rocuronium bromide prolongs emergence from propofol anesthesia in rats.PloS one · 2021Article
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
rationalePupil monitoring for neurologic examination has become a regular clinical practice during extracorporeal membrane oxygenation (ECMO) therapy. Sudden dilation of pupils always indicates a severe cerebrovascular event. However, bilateral dilated nonreactive pupils secondary to neuromuscular blockade are uncommon and widely ignored in adult acute respiratory distress syndrome (ARDS) patients. This is the first case report of bilateral dilated nonreactive pupils caused by rocuronium in an ARDS patient receiving ECMO treatment. PATIENT CONCERNS: Bilateral dilated nonreactive pupils were found in an ARDS patient who received V-V ECMO therapy. However, CT angiography did not indicate the occurrence of a cerebrovascular event. Drugs that could potentially result in dilated nonreactive pupils were checked. DIAGNOSIS: Bilateral dilated nonreactive pupils were caused by rocuronium infusion.
interventionsRocuronium infusion was stopped. OUTCOMES: Bilateral dilated nonreactive pupils were resolved 20 h after rocuronium infusion was stopped. LESSONS: Neuromuscular blockade should be taken into consideration when bilateral dilated nonreactive pupils are found in ARDS patients treated with ECMO therapy.
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