Systematic Early Use of Neuromuscular Blocking Agents in ARDS Patients

Conditions

ARDS

Keywords

ARDS, mortality, mechanical ventilation, pneumonia, muscle relaxants

Brief summary

The use of neuromuscular blocking agents (NMBA) in ARDS patients has not been extensively investigated. The aim of the study is to show a reduction of the mortality rate of ARDS patients.

Detailed description

The use of neuromuscular blocking agents (NMBA) in ARDS patients has not been extensively investigated. It has been recently demonstrated that a systematic 48-h infusion of NMBA is associated with a significant improvement in oxygenation as compared with a control group (Gainnier et al., Crit Care Med 2004). Moreover, a trend towards a reduction in the mortality rate has been observed. The aim of the study is to show a reduction of the mortality rate of ARDS patients.

Renard Triché L, Jabaudon M, Molinari N, Forel JM, Constantin JM, Pereira B, Chevret S.

2025-06-193 citations

10.1186/s13054-025-05474-9

Effect of driving pressure on mortality in ARDS patients during lung protective mechanical ventilation in two randomized controlled trials.

Guérin C, Papazian L, Reignier J, Ayzac L, Loundou A, Forel JM, investigators of the Acurasys and Proseva trials.

2016-11-29150 citations

10.1186/s13054-016-1556-2

Neuromuscular blockers in early acute respiratory distress syndrome.

Papazian L, Forel JM, Gacouin A, Penot-Ragon C, Perrin G, Loundou A, Jaber S, Arnal JM, Perez D, Seghboyan JM, Constantin JM, Courant P, Lefrant JY, Guérin C, Prat G, Morange S, Roch A, ACURASYS Study Investigators.

2010-09-011,530 citations

10.1056/nejmoa1005372

Interventions

DRUGcisatracurium

DRUGPlacebo

physiological serum infusion

DRUGCisatracurium besilate

Cisatracurium besilate infusion (900mg/day)

Study design

Allocation

RANDOMIZED

Intervention model

PARALLEL

Primary purpose

TREATMENT

Masking

QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)

Eligibility

Sex/Gender

ALL

Age

18 Years to 90 Years

Healthy volunteers

No

Inclusion criteria

* ARDS with a PaO2 / FiO2 \< 150 with a PEEP \> 5 since less than 48 hrs * informed consent

Exclusion criteria

* NMBA allergy * Continuous administration of NMBA for ARDS prior inclusion * Age \< 18 yrs * SAPS II \> 70 * Persistent air leak

Design outcomes

Primary

Measure	Time frame
Reduction of the mortality rate of ARDS patients at d90	36 months

Secondary

Measure	Time frame
Mortality at day 28, day 60, day 180 and ICU mortality, Ventilator-free days and alive at day 28 and day 60, Exposure time to FIO2 > 80% or PEEP > 10 cmH2O during the first 7 days, Sedatives and analgesics requirements during the first 7 days	march 2009
Organ failure-free days and alive at day 28, Incidence of barotrauma, Incidence of critical illness neuromyopathy, Incidence of ventilator-associated pneumonia, Quality of life at day 180	march 2009

Countries

France

Outcome results

None listed