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Neuromuscular Blockers in Early Acute Respiratory Distress Syndrome
Ist Teil von
The New England journal of medicine, 2010-09, Vol.363 (12), p.1107-1116
Ort / Verlag
Waltham, MA: Massachusetts Medical Society
Erscheinungsjahr
2010
Quelle
MEDLINE
Beschreibungen/Notizen
The investigators induced muscle paralysis in patients with the acute respiratory distress syndrome (ARDS) by administering a neuromuscular blocking agent, cisatracurium besylate. As compared with placebo, cisatracurium resulted in a lower adjusted 90-day mortality without more severe sequelae of neuromuscular blockade.
The acute respiratory distress syndrome (ARDS) is characterized by hypoxemic respiratory failure; it affects both medical and surgical patients.
1
Despite rigorous physiological management,
2
in most studies, ARDS has been fatal in 40 to 60% of patients.
3
–
7
Neuromuscular blocking agents are used in a large but highly variable proportion of patients with ARDS.
8
–
12
Current guidelines indicate that neuromuscular blocking agents are appropriate for facilitating mechanical ventilation when sedation alone is inadequate, most notably in patients with severe gas-exchange impairments.
10
In a four-center randomized, controlled trial of gas exchange in 56 patients with ARDS,
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infusion of a neuromuscular blocking agent . . .