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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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Abstract

The variability or inaccuracy of acceleromyographic measurements could interfere with the interpretation of the train-of-four (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.

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Authors and Affiliations

  1. Anesthesiology Department, CHU UCL Namur, Avenue Dr Gaston Thérasse, 1, 5530, Yvoir, Belgium

    Virginie Dubois, Guillaume Fostier, Marie Dutrieux & Philippe E. Dubois

  2. Scientific Support Unit, CHU UCL Namur, Avenue Dr Gaston Thérasse, 1, 5530, Yvoir, Belgium

    Jacques Jamart

  3. ENT Department, CHU UCL Namur, Avenue Dr Gaston Thérasse, 1, 5530, Yvoir, Belgium

    Stéphanie Collet, Clothilde de Dorlodot & Philippe Eloy

Authors
  1. Virginie Dubois
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  2. Guillaume Fostier
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  3. Marie Dutrieux
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  4. Jacques Jamart
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  5. Stéphanie Collet
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  6. Clothilde de Dorlodot
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  7. Philippe Eloy
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  8. Philippe E. Dubois
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Correspondence to Philippe E. Dubois.

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Conflict of interest

Dubois PE perceived grants from Merck Belgium for publications in the field of neuromuscular transmission monitoring development and honorarium for lectures but, as all co-authors, has no conflict of interest with the present study.

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Dubois, V., Fostier, G., Dutrieux, M. et al. Philips Intellivue NMT module: precision and performance improvements to meet the clinical requirements of neuromuscular block management. J Clin Monit Comput 34, 111–116 (2020). https://doi.org/10.1007/s10877-019-00287-y

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  • DOI: https://doi.org/10.1007/s10877-019-00287-y

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